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we San Joaquin County Is Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.sigov.org/ehd Hazardous Materials Program Inspection Report Facility Name: Facility Phone: Date: BURGER KING#10834 209 931-3820 Aril 14, 2015 Facility Address: CERS ID: 4608 E WATERLOO STOCKTON CA 95205 10182263 Inspection Contact: Title: Phone: Tami Hilscher Tami Hilscher 209 931-3820 Inspection Type: Program: ROUTINE INSPECTION -O eratin Permit 1 - HMBP-Regular-Primary Location Consent For: Consent Given By: Inspection Photos Sannla4rrO I Tami Hilscher. Manager CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations V=Violation R=Repeat violation COS=Corrected on site during inspection Violations 1 HSC 25507 Failed to establish and implement a hazardous materials business plan ❑V ❑R o COS 2 HSC 25508(a)(1) Failed to electronically submit a business plan ❑V ❑R ❑COS 3 HSC 25508(c) Failed to annually review and certify that the business plan is complete,accurate,and up to date ❑V n R ❑COS 4 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program in V o R o COS 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center ❑V n R ❑COS 6 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page ❑V ❑R ❑COS 7 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site ❑V ❑R in COS 8 HSC 25508.1(a)-(e) Failed to submit revisions to HMBP within 30 days of change in business info or inventory o V ❑R ❑COS 9 HSC 25508.1(f) Failed to submit revisions to HMBP within 30 days of substantial change in operations ❑V ❑R ❑COS 10 HSC 25505(a)(2) Failed to complete and/or submit a site map with all required content ❑V ❑R ❑COS 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release o V ❑R ❑COS 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility ❑V ❑R ❑COS 13 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel ❑V ❑R n COS 14 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements ❑V ❑R n COS 15 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements ❑V ❑R ❑COS 16 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions ❑V n R ❑COS 17 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report o V ❑R ❑COS 1010 See below Unlisted Administration/Documentation violation ❑V c R ❑COS 1040 See below Unlisted Release/Leaks/Spills violation o V ❑R o COS SUMMARY OF VIOLATIONS (CLASS 1,CLASS II,or MINOR-Notice to Comply) Item # Remarks Overall Inspection Comments: No violations noted at time of inspection. Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement documenting the corrective actions that have been or will be taken for each violation, and any supporting Received by Inspector: Phone: Date: (irigaq: JAMIE DE LA ROSA, HM Specialist II (209) 953-6211 04/14/2015 Page 7 of 2