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11 <br />Page 1 of 2 <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www sjgov.org/ehd <br />Hazardous Materials Program Inspection Report <br />Facility Name: <br />RALEYS FUEL STATION 1*56 <br />Facility Phone: <br />916 373-3333 <br />Date: <br />July 28 2015 <br />Facility Address: <br />4219 E MORADA LN STOCKTON CA 95212 <br />CERS ID: <br />10185183 <br />Inspection Contact:Title: <br />Dawn Dircksen <br />Mana er <br />Phone: <br />209 603-8699 <br />Inspection Type: <br />ROUTINE INSPECTION <br />- O eratin Permit <br />Program: <br />1921 - HMBP-Regular-Primary Location <br />Consent For: <br />O Inspection El Photos <br />Consent Given By: <br />❑ Samples Dawn Diricksen Manager <br />CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations <br />V = Violation R = Repeat violation COS = Corrected on sRe during inspection <br />Violations <br />1 <br />HSC 25507 <br />Failed to establish and implement a hazardous materials business plan <br />❑ V ❑ R ❑ COS <br />2 <br />HSC 25508(a)(1) <br />Failed to electronically submit a business plan <br />❑ V ❑ R ❑ COS <br />3 <br />HSC 25508.2 <br />Failed to annually review and certify that the business plan is complete, accurate, and up to date <br />■ V ❑ R ❑ COS <br />4 <br />HSC 25505.1 <br />Failed to notify property owner that facility is subject to and in compliance with the HMBP program <br />❑ V ❑ R ❑ COS <br />5 <br />HSC 25510 <br />Failed to report actual or threatened release to the EHD and/or CalOES Warning Center <br />❑ V ❑ R ❑ COS <br />6 <br />HSC 25508(a)(1) <br />Failed to complete and/or submit the Business Activities or Owner/Operator Identification page <br />❑ V ❑ R ❑ COS <br />7 <br />HSC 25506(a) <br />Failed to complete and/or submit hazardous materials inventory for all reportable materials on she <br />■ V ❑ R ❑ COS <br />8 <br />HSC 25508.1(a) -(e) <br />Failed to submit revisions to HMBP within 30 days of change in business info or inventory <br />❑ V ❑ R ❑ COS <br />9 <br />HSC 25508.1(f) <br />Failed to submit revisions to HMBP within 30 days of substantial change in operations <br />❑ V ❑ R o COS <br />10 <br />HSC 25505(a)(2) <br />Failed to complete and/or submit a site map with all required content <br />❑ V ❑ R ❑ COS <br />11 <br />HSC 25505(a)(3) <br />Failed to establish and/or submit emergency response procedures for a release or threatened release <br />❑ V in R ❑ COS <br />12 <br />HSC 25505(a)(4) <br />Failed to submit a training program or program is not reasonable or adequate for facility <br />o V ❑ R ❑ COS <br />13 <br />HSC 25505(a)(4) <br />Failed to provide or document initial and/or refresher training to appropriate personnel <br />❑ V o R ❑ COS <br />14 <br />HSC 25507.1 <br />Failed to submit emergency response plan when not meeting Ag handler exemption requirements <br />o V ❑ R ❑ COS <br />15 <br />HSC 25507.1 <br />Failed to submit training program when not meeting Ag handler exemption requirements <br />c V ❑ R ❑ COS <br />16 <br />HSC 25507.2 <br />Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions <br />❑ V ❑ R ❑ COS <br />17 <br />HSC 25511 <br />Failed to submit a written response within 30 days of receiving an inspection report <br />❑ V ❑ R in COS <br />1010 <br />See below <br />Unlisted Administration/Documentation violation <br />❑ V ❑ R ❑ COS <br />1040 <br />See below <br />Unlisted Release/Leaks/Spills violation <br />o V o R c COS <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />Item # <br />Remarks <br />Received by <br />(initial): <br />Inspector: <br />NICHOLAS LOEHRER, HM Specialist 1 <br />Phone: <br />(209) 468-0623 <br />Date: <br />07/28/2015 <br />Page 1 of 2 <br />