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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 . socehd . com <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> Facility Facility Inspection <br /> Name: C e't0% Cu- ' ' _ Q G C r ✓� L, L [� Phone : z — +I- (# � OOc Date : 9 <br /> Facility L <br /> Address: ERS <br /> ,n� Q z'L c� +x,, L � � u� Z0 3 D : <br /> Inspection Title : � ! 6 <br /> C \ ✓ CSM4 Phone: <br /> Contact: cb L + O Oer � k �}- Q r-� - C20 � '�. 2 <br /> Inspectio r Program: r <br /> Type : o c ' c vy � ' 0 sz& 1 9-�.r yK ^� 2 1 <br /> Consent Given For: Consent <br /> Inspection XPhotos ❑ Sampling Given By: Edi UV 4F�- VA (3C5 <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 255059 Failed to complete and electronically submit a hazardous materials business Ian V335 <br /> 25508 a 1 p ( ) ❑ ❑ ❑ <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 (v348) ❑ ❑ ❑ <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 (a4) Failed to submit revisions to HNIBP 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) X ❑ <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) 13 El <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 I , 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 /> Recei d by (signature): Title: Date : <br /> Received by (printe name) : Inspector: Inspector phone: <br /> ZO 9 9S3 toZ/ (sk <br /> EHD 19-01 REV 07/28/16 Page 1 HM INSPECTION REPORT <br />