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San Joaquin County 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: Costco Wholesale #210 Facility Phone: (209) 221-6200 Date: June 21, 2017 Facility Address: 17880 W Schulte Rd, Tracy, CA 95377 CERS 10: 10146169 8lapecson Contact: Kevin Smith Title: Assistant Vice President Phone: (209) 629-4455 Inspection Type:Program: ROUTINE INSPECTION - Operating Permit 1921 - HMBP-Regular-Primary Location Convent Fer. Consent Given By: O Inspection © Photos 0 Sample Kevin Smith, Assistant Vice President CCR • Celifema Coee of Reguisoom NSC - Health and Safety Cade CFR = Code or Federal Regulations V = vsauon R - Repeat violabon Cos • canectao on yea dens inspection . , VIOWtIOM' 1 SJO 4432 Failed to pay annual operating fees o V o R o COS 2 HSC 26605.25506(a) i Failed to complete and electronically submit a hazardous materials business plan o V o R o COS 3 HSC 25507 Failed to establish and implement a hazardous materials business plan a V in R r. COS 4 HSC 25608(s)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page a V R : COS 5 HSC 25506(8) Failed to complete and/or submit hazardous mstenals Inventory for all reportable materials on site a V R COS 6 HSC 25505(a)(2) Failed to complete and/or submit a site map with all required content a V _ R COS 7 HSC 25505(8)(3) Failed to establish and/or submit emergency response procedures for a release w threatened release o V R r. COS B HSC 25505(8)(4) Failed to submit a training Program or program is not reasonable or adequate for facility o V _ R _ COS 9 FISC 255082 Failed to annually review and cantly that the business pan is complete. accurate. and up to date o V -. R - COS 10 HSC 25508.1(6- Failed to submit revisions to business pan within 30 days of substantial change in operations o V c R u COS 11 HSC 25505(x)(4) Failed to provide or document initial andror refresher training to appropriate personnel v V o R n COS 12 NSC 25505(c) Failed to have the business pan readily available to facliity, or EHD personnel n V c R a COS 13 NSC 25505.1 Failed to hotity property owner that faciiiry is subject to and in compliance with the HMBP program a V o R c COS 14 HSC 25510 Failed to report actual or threatened release to the EMD and/or CaIOES Warning Center it V a R o COS 15 HSC 25607.1 Failed to submit emergency response pan when not meeting Ag handler exemption requirements o V o R o COS 16 HSC 25507.1 Failed to submit training program when net meefing Ag handler exemption requirements a V v R c COS 17 HSC 255072 Failed to establish ane implement a HMBP when hot meeting remote unstaffed facility exemptions _ V o R o COS 18 HSC 25511 Failed to submit a written response wain 30 days of receiving an inspection repent o V u R o COS 1010 See below United d AdministratiowDocumenation violation o V in R n COS Unlisted ReleasefLeaksispllls violation o V : R COS 1040 See below SUMMARY OF VIOLATIONS .,. (CLASS 1, CLASS 11, or MINOR - Notice to Comply) Item 4 Remarks 5 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site. 4,400 gallons of Purac Form SD 4 were found on site that have not been reported. Any material that meets or exceeds the reportable quantity shall be reported in the facility's business plan. Immediately log into the California Environmental Reporting System (CERS) at hitp7/cers.calepa.ce.gov/, add the materials to the hazardous material inventory, and submit to the EHD for approval. This is a minor violation. END 19-01 Rw. 0922/16 FA0010273 PRO512561 SC001 062112017 Pape 1 Of 2 Hazardous kiaterah Program OIR