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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.s'cehd.com <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> Facility <br /> Name: � Facility Inspection <br /> Phone:-­� i Date: <br /> Facility '. L <br /> Address: �4 ('� M C'A wn .4`. `Ci'f ©�1�a T 0,.A 9-5-2 0 d ID: AAD <br /> Inspection ^ Title: <br /> Contact: (y �M../, a G �, C i 0 W " Q f Phone: <br /> z.t:!j ♦- <br /> Inspection n ,� L Program: <br /> Type: t. . G fi '. 0 +�✓O. f� -C✓v� i T Z-C) <br /> Consent Given For: IConsent <br /> ❑ Inspection ❑ Photos ❑ Sampling I Given By: �Gt ✓; -� r ,, r. �� ,:+ ; <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 x505, 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) a ❑ ❑ <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) ti 11 1-16 HSC 25505(a)(3) Failed to complete and/or submit a site map with all required content(V347) a ❑ ❑ <br /> 7 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release(v34e) tl ❑ ❑ <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-f) 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) ❑ ❑ <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 CalOES 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 See below Unlisted Administration/Documentation violation(V355) ❑ ❑ ❑ <br /> 1040 See below Unlisted Release/Leaks/Spills violation(V356) ❑ ❑ ❑ <br /> SUMMARY OF VIOLATIONS <br /> CLASS 1 CLASS II,or MINOR—Notice to comply <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: <br /> Received by(printed name): Inspector: Inspector phone: <br /> EHD 19-01 REV 07/28/16 Pagel HM INSPECTION REPORT <br />