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San Joaquin County <br /> as Environmental Health Department <br /> 1868 EHazelton Avenue, Stockton, California 95 -6232 <br /> Telephone:(209)468-3420 Fax: (209)468-3433 Web:www.s'gov.ora/ehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Phone: Date: <br /> FLYING J TRAVEL PLAZA#617 209 3394066 June 11 2015 <br /> Facility Address: CERS ID: <br /> 15237 N THORNTON RD LODI CA 95242 10184349 <br /> Inspection Contact: Title: Phone: <br /> Jose Jimenez General Mana er 209 3394066 <br /> Inspection Type: Program: <br /> ROUTINE INSPECTION -Operating Permit 1921 - HMBP-Regular-Primary Location <br /> Consent For: Consent Given By: <br /> Z Inspection N Photos ❑ Samples Jose Jimenez General Manager <br /> CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations <br /> V=Violation R=Repeat violation COS=Connected on site during inspection <br /> Violations <br /> 1 HSC 25507 Failed to establish and implement a hazardous materials business plan ❑V ❑R ❑COS <br /> 2 HSC 25508(a)(1) Failed to electronically submit a business plan ❑V o R o COS <br /> 3 HSC 25508.2 Failed to annually review and certify that the business plan is complete,accurate,and up to date ❑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 ❑COS <br /> 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center ❑V a R a 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 and/or submit hazardous materials inventory for all reportable materials on site ❑V ❑R ❑COS <br /> 8 HSC 25508.1(a)-(e) Failed to submit revisions to HMBP within 30 days of change in business info 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 ❑V o R ❑COS <br /> 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release ❑V o R o COS <br /> 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility ❑V ❑R o COS <br /> 13 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel ❑V ❑R ❑COS <br /> 14 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements o 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 ❑R ❑COS <br /> 17 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report o V o R o COS <br /> 1010 See below Unlisted Administration/Documentation violation ❑V ❑R ❑COS <br /> 1040 See below Unlisted Release/Leaks/Spills violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> Overall Inspection Comments: <br /> No violations noted at time of inspection. <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> Received by Inspector: Phone: Date: <br /> (initial): JAMIE DE LA ROSA, HM Specialist II (209) 953-6211 06/11/2015 <br /> Page 1 of 2 <br />