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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.sicehd.com <br /> A <br /> till lis; M TL1-aR 1 PR(7G,, I►�SP,^�EC O REP RT t iS € <br /> Nam rn�`LI � `t5,TA--i <br /> Facility Inspection /S <br /> Names J k-�I�$ riw.iv �(LL Phone: ��'/� �.�-� Date: <br /> Facility },r '/� �[ /� CERS <br /> Address: gill a)�� N{}(nom l 4F-�"'-Y CA %,5-30 ID: <br /> Inspection TPhone: <br /> contact: VILNAA pILTTlii MAY-J0rf—EP— 2.04- 835- 7>6 <br /> TYPT.Inspeon Coll N il Program: ) -)2--1-)�1 <br /> Type: <br /> Consent Given For. Consent <br /> d(nspect on photos ❑Sampling I Given By: VI L MA YOP—TI tL 0 <br /> CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations <br /> V=Violation R=Repeat COS=Conected on site during inspection <br /> _ ... _ _ <br /> 1 HSC 25507 Failed to establish and implement a hazardous materials business plan(V334) ° ° <br /> 2 HSC 25508(a)(1) Failed to electronically submit a business plan(V335) ° ° <br /> 3 HSC 25508.2 Failed to annually review and certify that the business plan Is complete,accurate,and up to date(V342) ❑ ❑ <br /> 4 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program(V341) ❑ ❑ ❑ <br /> 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center(\1338) 0❑ o ❑ <br /> 6 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or OwnedOperator Identification page(V345) ,p- ° ❑ <br /> 7 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site(V343) ❑ ❑ <br /> 8 HSC 25608.1(a)-1 Failed to submit revisions to HMBP within 30 days of change in business info or inventory(V346) ❑ ❑ ❑ <br /> 9 HSC 25508.1(1) Failed to submit revisions to HMBP within 30 days of substantial change in operations(V344) ❑ ❑ ° <br /> 10 HSC 25505(a)(2) Failed to complete and/or submit a site map with all required content(V347) ,a' ° ° <br /> 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release(vi ❑ ❑ <br /> 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility(V350) ❑ ° <br /> 13 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel(V349) ❑ ❑ ° <br /> 14 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handier exemption requirements(351) ❑ ❑ ❑ <br /> 15 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements(V352) ❑ ❑ ❑ <br /> 16 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility,exemptions(V353) ❑ ❑ ❑ <br /> 17 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report(V808) ❑ ❑ ° <br /> 1010 See below Unlisted AdministrationlDocumentatfon violation(V355) <br /> 1040 See below Unlisted ReleaselLeaksfSpills violation(V356) <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II, or MINOR-Notice to Goal <br /> ' OJ/-rD OF Z �p7Nr6 oN 7- TIfE A& <br /> L t-*PC�TLmI-/ <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES MLL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANYTIME AT EHD'S CURRENT HOURLY RATE. <br /> FReweied <br /> y(sl TiUe: Date: <br /> y(pn e): Inspector. Inspector phone: <br /> 14 Ao -T r L,>M6A�Qp\ 205— 93-3 6x13 <br /> EHD 19-01 REV 04/23/15 Page 1 HM INSPECTION REPORT <br />