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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 . secehd . com <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> Facility <br /> Name : Facility .. � j— nspection <br /> 424;4 CA 14W L1, Phone : - �j Date : 2 / 2- 9111 <br /> Facility AA <br /> Address: 20 © y- 1 _ ` G'.yr, S A- 4 6410C Oc/1 Cis ZO S CERS <br /> ID: AA) `� <br /> Inspection 1 / Title: hone: e <br /> Contact: � VU, Vi s ' c 4._Cl 4 �raYci O it l� ✓� �-� : 70 <br /> 22U 7 <br /> Inspection � ll Program : <br /> Type: /2o "'4-i ^ e. C; n •e V 6t v i T g 2- b <br /> Consent Given For: Consent V / <br /> Xinspection Photos ❑ Sampling Given By: c ✓ / L tic H ck 6;..� A � <br /> CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations 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 ,25508 (a) ( 1 ) Failed to complete and electronically submit a hazardous materials business plan (V335) �!( ❑ ❑ <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 (va4e) ❑ ❑ A <br /> 8 HSC 25505 (a) (4) Failed to submit a training program or program is not reasonable or adequate for facility (V350) ❑ �Q_ (� <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 (a4) Failed to submit revisions to HNIBP within 30 days of substantial change in operations (V346) ❑ Cl ❑ <br /> 11 HSC 25505 (a) (4) Failed to provide or document initial and/or refresher training to appropriate personnel (V349) <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) Cl ❑ ❑ <br /> 18 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report (V808) ❑ ❑ ❑ <br /> 1010 See below Unlisted Administration/Documentation violation (V355) ❑ ❑ ❑ <br /> 1040 See below Unlisted Release/Leaks/Spills violation (V356) ❑ ❑ ❑ <br /> SUMMARY OF VIOLATIONS <br /> CLASS I, CLASS II, or MINOR — Notice to Comply / <br /> n 1 /c c vt a 4wS� l ac, .-. <br /> RE <br /> Ale.. Pi!'7 O ,� <br /> ALL EHD StAFF TIVE 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: <br /> Received by (printed name): Inspe r Inspector phone: <br /> EHD 19-01 REV 07/28/1 Page 1 HM INSPECTION REPORT <br />