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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 />EHD is -u i REV uucoa io _ rage 7 HM INSPECTION REPORT <br />HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br />Fautility <br />Name: <br />t f <br />Facility <br />Phone: Zpg— 27/-527,3 <br />Inspection <br />Date: Z ZZ <br />Facility ^ rr <br />Address: 0 2/ G Q ✓j e. ,.S Q <br />CERS <br />ID: <br />Inspection <br />Contact q <br />TiOE <br />yL v- <br />Phone: <br />209 -27/-5L73 <br />Inspection <br />Ty pe' <br />` <br />Pmgmm: 0 <br />67 <br />/ Z <br />C Sent Given For. Consent J/ <br />nspection'otos D Sampling Given By: c�.. <br />CCR = California ode of Regulations HSC = Health and afety CFR = Coda of Federal Regulations SJO = San Joaquin County Ordinance <br />V = Violation R = Repeat COS = Corrected on site during inspection <br />Vlolatlons V R COS <br />1 SJO 4432 <br />Failed to pay annual operating fees (V851) ❑ ❑ ❑ <br />2 HSC 25505, <br />25508 a 1 <br />Failed to complete and electronically submit a hazardous materials business Ian <br />p (V335) X ❑ ❑ <br />3 HSC 25507 <br />Failed to establish and Implement a hazardous materials business plan (V334) X ❑ ❑ <br />4 HSC 25508(a)(1) <br />Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345) ❑ ❑ <br />5 HSC 25506(a) <br />Failed to complete and/or submit hazardous materials Inventory for all reportable materials on site (V343) X ❑ o <br />6 HSC 25505(x)(3) <br />Failed to complete and/or submit a site map with all required content (V347) X ❑ ❑ <br />7 HSC 25505(a)(3) <br />Failed to establish and/or submit emergency response procedures for a release or threatened release Rum A' o ❑ <br />8 HSC 25505(x)(4) <br />Failed to submit a training program or program is not reasonable or adequate for facility (V350) ❑ ❑ ❑ <br />9 HSC 25508.2 <br />Failed to annually review and certify that the business plan is complete, accurate, and up to date (V342) ❑ ❑ ❑ <br />10 HSC 25508.1(a -f) <br />Failed to submit revisions to HMBP within 30 days of substantial change In operations (V346) ❑ ❑ ❑ <br />11 HSC 25505(a)(4) <br />Failed to provide or document initial and/or refresher training to appropriate personnel (V349) ❑ ❑ ❑ <br />12 HSC 25505(c) <br />Failed to have the business plan readily available to facility or EHD personnel (V850) xr ❑ ❑ <br />13 HSC 25505.1 <br />Failed to notify property owner that facility, is subject to and in compliance with the HMBP program (V341) ❑ ❑ o <br />14 HSC 25510 <br />Failed to report actual or threatened release to the EHD and/or CaIOES Waming Center (V338) ❑ ❑ ❑ <br />15 HSC 25507.1 <br />Failed to submit emergency response plan when not meeting Ag handler exemption requirements (351) ❑ ❑ ❑ <br />16 HSC 25507.1 <br />Failed to submit training program when not meeting Ag handler exemption requirements (V352) ❑ ❑ a- <br />17 HSC 25507.2 <br />Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions (V353) ❑ ❑ ❑ <br />18 HSC 25511 <br />Failed to submit a written response within 30 days of receiving an inspection report (V808) ❑ ❑ ❑ <br />1010 See below <br />Unlisted Administration/Documentation violation (V355) ❑ ❑ ❑ <br />1040 See below <br />Unlisted Release/LeaWSpills violation (V356) ❑ ❑ ❑ <br />SUMMARY OF VIOLATIONS <br />CLASS I, CLASS II, o MINOR –. Notice W Comply <br />61 <br />o <br />t CY I I <br />✓e <br />o in <br />2a <br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANYTIME AT EHD'S CURRENT HOURLY RATE. <br />Received by (signature): <br />Ti e: <br />Gel G-7 <br />Date: <br />Received by(prin e): <br />(-,I1,57 <br />Inspector. <br />JR, LeJ I., .e_.7 <br />mspectorphone: <br />Noe?) 15'3-bZ/4 <br />EHD is -u i REV uucoa io _ rage 7 HM INSPECTION REPORT <br />