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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 /> HAZARDOUS MATERIALS 3ROGRAM INSPECTION REPORT <br /> Facility Facy o Inspection <br /> Name Phone: 2 �—�T q—l.�O Date: <br /> Facility CERS <br /> Address: Ph <br /> Inspection Ti �q Phone: <br /> Contact: a✓ Ni vtivl.Qc�` 99 2- O <br /> Inspection ecr f aK 1 ' Program: 1 <br /> Type: T <br /> Consent Given For. Consent <br /> spection2hotos ❑ Sampling Given By: .� <br /> CCR=Califomia Code of Regulations HSC=Hearm and Safety Co a CFR=Code of Federal Pegilkns SJO=San Joaquin County Ordinance <br /> V=Violation R=Repeat COS=Corrected on site during inspection <br /> Violations V R COS <br /> 1 SJO 4432 Failed to pay annual operating fees(V851) <br /> 2 HSC 25505, Failed to complete and electronically submit a hazardous materials business plan(V335) ❑ ❑ <br /> 25508 a 1 <br /> 3 HSC 25507 Failed to establish and implement a hazardous materials business plan(V334) <br /> 4 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page(V345) ❑ ❑ <br /> 5 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site(V343) ❑ ❑ <br /> 6 HSC 25505(a)(3) Failed to complete and/or submit a site map with all required content(V347) <br /> 7 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release Nuri) ,k(. ❑ ❑ <br /> 8 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility(V350) ❑ ❑ <br /> 9 HSC 25508.2 Failed to annually review and certify that the business plan is complete,accurate,and up to date(V342) ❑ ❑ <br /> 10 HSC 25508.1(a-0 Failed to submit revisions to HMBP within 30 days of substantial change in operations(V346) ° ° ❑ <br /> 11 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel(V349) SG ° ❑ <br /> 12 HSC 25505(c) Failed to have the business plan readily available to facility or EHD personnel(V850) ,¢ ❑ ° <br /> 13 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program(V341) ❑ ❑ ❑ <br /> 14 HSC 25510 Failed to report actual or threatened release to the EHD and/or CaIOES Warning Center(V338) ❑ ❑ ❑ <br /> 15 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements(351) ❑ ❑ ❑ <br /> 16 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements(V352) ❑ ❑ ❑ <br /> 17 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions(V353) ❑ ❑ ❑ <br /> 18 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report(V808) ❑ ❑ ❑ <br /> 1010 j See below Unlisted Administration/Documentation violation(V355) ° 00 <br /> 1040 1 See below Unlisted Release/Leaks/Spills violation(V356) <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS II,or MINOR—Notice to Com I <br /> am /Jc .tC 16 <br /> !rS el <br /> / <br /> �CY'fc•�'ie-� `L4S b¢-¢.ti O1s'i e. c. � T`owr �u <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 ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by(signature): Title: Date: t7 <br /> W <br /> X11 <br /> me): Ins r Inspector phone: / <br /> I ib:, Ilro 2Z �� Qs� -102-1 <br /> 41 <br /> I6 Page 1 HM INSPECTION REPORT <br />