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IVSD b")v % 9 mn San Joaquin County ENVIROIlIMENTAL Environmental Health Department PERMIRSER Sl H TFi 1868 East Hazelton Avenue, Stockton, California 95205-6232 VIOE$ Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd Hazardous Materials Program Inspection Report Facility Name: DELTA SIERRA DIALYSIS CNTR Facility Phone: (209) 473-2294 Date: August 11, 2017 Facility Address: 555 W BENJAMIN HOLT DR, STOCKTON, CA 95207 CERS to: 10183617 Inspection Contact:Title: Shawn Awan Administraotr Phone: (209) 473-2294 Inspection Type:Program: ROUTINE INSPECTION - Operating Permit 1921 - HMBP-Regular-Primary Location Consent For. 0 Inspection ❑ Photos ❑ Samples I =Given By: Shawn Awan, Administrator CCR= Califomia 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 SJO 4432 Failed to pay annual operating fees o V o R o COS 2 HSC 25505, 25508(x) 1 Failed to complete and electro ly submit a hazardous materials business plan o V in R in COS 3 HSC 25507 Failed to establish and implement a hazardous materials business plan o V o R o COS 4 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page s V o R o COS 5 HSC 25508(.) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site . V D R o COS 6 HSC 25505(a)(2) Failed to complete and/or submit a site map with all required content o V o R o COS 7 HSC 25505(x)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release . V o R o COS 8 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility . V to R o COS 9 HSC 25508.2 Failed to annually review and certify that the business plan is complete, accurate, and up to date o V o R o COS 10 HSC 25508.1(a) -(f) Failed to submit revisions to business plan within 30 days of substantial change in operations o V o R o COS 11 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel s V o R o COS 12 HSC 25505(.) Failed to have the business plan readily available to facility or EHD personnel s V o R o COS 13 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 14 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Waning Center o V o R in COS 15 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements o V o R o COS 16 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements o V o R o COS 17 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions o V o R o COS 18 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report o V o R o COS 1010 See below Unlisted Administration/Documental violation o V in R o COS 1040 See below Unlisted Release/Leaks/Spills violation V R -. COS SUMMARY OF VIOLATIONS (CLASS I, CLASS it, or MINOR - Notice to Comply) Item # Remarks 4 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page. The Business Owner/Operator Identification form was not updated when previous administrator left facility . This information must be current and submitted as part of the business plan. Immediately log into the California Environmental Reporting System (CERS) at http://oers.calepa.c-a.gov/, enter the cored or updated information, and submit to the EHD for approval. This is a minor violation. FA0010525 PRO520400 50001 08/112017 EHD 19-01 Rev. 09122/16 Page 1 of 3 Hazardous Materials Program OIR