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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 Web.www.siaov.org/ehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility one: Date: <br /> Kmart#4862 9) 825-3C" Januar; <br /> FacilityAddress: CERS to: <br /> 255 Northgate Dr, Manteca, CA 95336 10140687 <br /> InspectionContact: le: one: <br /> Alma Robles Store Manay-, (209) 825-3033 <br /> n on ype20rogram: <br /> ROUTINE INSPECTION- Operating Permit 19oP-Ca., :Ion Mate: �sls <br /> Consent For: I Consent Given By: <br /> O Ins ection ❑ Photos ❑Sam les Alma Robles, Store Manager <br /> CCR=Caldornia Cade of Regulations HSC=Health and Safety Cade CFR=Code o(Federal Regulations <br /> V=Violation R=Repeat violation COS=Corrected on site during inspection <br /> Violations <br /> 1 HSC 25507 Failed to establish and implement a hazardous materials business plan o V n R o COS <br /> 2 HSC 25508(a)(1) Failed to electronically submit a business plan ❑V ❑R ❑COS <br /> 3 HSC 25508.2 Failed to annually review and certify that the business plan is complete,accurate,and up to date o V ❑R ❑COS <br /> 4 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program o V o R o COS <br /> 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center o V ❑R o COS <br /> 6 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page ❑V ❑R ❑COS <br /> 7 HSC 25506(a) Failed to complete andlor submit hazardous materials inventory for all reportable materials on site a V o R o COS <br /> 8 HSC 25508.1(a)-(e) Failed to submit revisions to HMBP within 30 days ofchange in business into or inventory ❑V ❑R ❑COS <br /> 9 HSC 25508.1(1) Failed to submit revisions to HMBP within 30 days of substantial change in operations ❑V ❑R ❑COS <br /> 10 HSC 25505(a)(2) Failed to complete and/or submit a site map with all required content o V o R ❑COS <br /> 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures fora release or threatened release ❑V ❑R ❑COS <br /> 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility ❑V ❑R ❑COS <br /> 13 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel o V ❑R ❑COS <br /> 14 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements ❑V ❑R ❑COS <br /> 15 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements ❑V ❑R ❑COS <br /> 16 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions o V o R ❑COS <br /> 17 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report ❑V ❑R ❑COS <br /> 1010 See below Unlisted Administration/Documentation violation ❑V ❑R ❑COS <br /> 1040 See below Unlisted Release/Leaks/Spills violation o V ❑R o COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS 11,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> Overall Inspection Comments: <br /> No violations found at time of inspec.. ., <br /> Please be aware as of January 1, 2013, all businesses are required to submit all hazardous materials <br /> information online to the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov. Be <br /> eeelve y Inspector: e: Date: <br /> (initial): NICHOLAS LOEHRER, HM Specialist I (209)468-0623 01/04/2016 <br /> Page 1 of 2 <br />