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San Joaquin County ND Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 �S 9�5, , Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd Hazardous Materials Program Inspection Report Facility Name: Facility Phone: Date: ROUND TABLE PIZZA 1(209) 951-6863 September 25, 2014 Facility Address: EPA ID: CERS ID: 10952 TRINITY PKWY, STOCKTON, CA 95219 1 10185205 Facility Contact: Contact Phone: Contact during inspection,if Brandy Wilder (209) 951-6863 different from facility contact: Inspection type: Program: ROUTINE INSPECTION - Operating Permit 1 1921 - HMBP-Regular-Primary Location 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 o R o COS 2 HSC 25508(a)(1) Failed to electronically submit a business plan ■V ❑R o COS 3 HSC 25508(c) Failed to annually review and certify that the business plan is complete,accurate,and up to date ❑V ❑R ❑COS 4 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program ❑V ❑R ❑COS 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center ❑V ❑R c 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 ❑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 o R o COS 9 HSC 25508.1(f) Failed to submit revisions to HMBP within 30 days of substantial change in operations ❑V ❑R o 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 ■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 initial and/or refresher training to appropriate personnel ❑V ❑R ❑COS 14 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements ❑V ❑R ❑COS 15 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements ❑V o R ❑COS 16 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions o V ❑R ❑COS 17 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report ❑V ❑R ❑COS 1010 See below Unlisted Administration/Documentation violation ❑V ❑R ❑COS 1040 See below Unlisted Release/Leaks/Spills violation o V o R o COS SUMMARY OF VIOLATIONS (CLASS I,CLASS II,or MINOR-Notice to Comply) Item# Remarks Received by(initial): Inspector: Phone: Date: HAZA SAEED, HM Specialist 1 (209) 953-6212 09/25/2014 Page 1 of 3