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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telej ihone:(209)468-3420 Fax:(209)468-3433 Web:www.socehd.com <br /> 1 HA DQUS` PROGRAM INSPECTION REPORT 57 <br /> ., r ..:. <br /> Facility Facility Inspection <br /> Name: {, �('eat Phone: —I 7S Z Date: 31111/ <br /> Facility _ CERS <br /> Address: ZZS ZS S tj ID: <br /> InspectionTi : Phone: I <br /> Contact: 961, MG Z S�-/ <br /> InspectiontA_ ) _ Q, Program: <br /> �� Z v <br /> Type: [ GC -cg 1% U/ 6 <br /> Consent Given For: Consent p_ <br /> Inspection ' Photos ❑ Sampli g Given By: 17U� INA <br /> CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations <br /> V=Violation R=Repeat COS=Corrected on site during inspection <br /> Violations V R COS <br /> 1 HSC 26907 -Failedt abiisa-and ivaPlemeni-a hazardous materials business plan(V334) ❑ o ❑ <br /> 2 HSC 25508(a)(1) Failed to electronically submit a business plan(V335) ❑ ❑ <br /> 3 HSC 25508(c) Failed to annually review and certify that the business plan is complete,accurate,and up to date(V342) ❑ ❑ ❑ <br /> 4 HSC 25505.1 Failed tc notify property owner that facility is subject to and in compliance with the HMBP progra 341) ❑ ❑ ❑ <br /> 5 HSC 25510 Failed tc report actual or threatened release to the EHD and/or CalOES Warning Cente 38) ❑ ❑ ❑ <br /> 6 HSC 25508(a)(1) Failed tc complete and/or submit the Business Activities or Owner/Operator iication page(V345) ❑ ❑ ❑ <br /> 7 HSC 25506(a) Failed tc complete and/or submit hazardous materials inventory foeportable materials on site(V343) Cl ❑ ❑ <br /> 8 HSC 25508.1(a)-(e) Failed td submit revisions to HMBP within 30 days of chang )n business info or inventory(V346) ❑ ❑ ❑ <br /> 9 HSC 25508.1(f) Failed tc submit revisions to HMBP within 30 d#y of substantial change in operations(V344) ❑ ❑ ❑ <br /> 10 HSC 25505(a)(2) Failed tc complete and/or submit a site-map with all required content(V347) ❑ ❑ Cl <br /> 11 HSC 25505(a)(3) Failed tc establish and/or submit emergency response procedures for a release or threatened release(v34e) ❑ ❑ ❑ <br /> 12 HSC 25505(a)(4) Failed tc submit a training program or program is not reasonable or adequate for facility(V350) ❑ ❑ ❑ <br /> 13 HSC 25505(a)(4) Failed t provide or document initial and/or refresher training to appropriate personnel(V349) ❑ ❑ ❑ <br /> 14 HSC 25507.1 Failed t submit emergency response plan when not meeting Ag handler exemption requirements(351) ❑ Cl Cl <br /> 15 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements(V352) ❑ ❑ ❑ <br /> 16 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions(V353) ❑ ❑ ❑ <br /> 17 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report(V808) ❑ ❑ ❑ <br /> 1010 See below UnlistedAdministration/Documentation violation(V355) ❑ ❑ ❑ <br /> 1040 See below UnlistedRelease/Leaks/Spills violation(V356) ❑ ❑ ❑ <br /> SUMMARY OF'VIOLATIONS <br /> ' CLASS I CLASS II or MINOR-Notice to Comply <br /> M EiW 112, DPe Gy-w/ 9�>y/i� e D Z SZ 3� <br /> r��G�.e� �t,-t -/Lu, v✓LY� �� �.0�`tl�n-I,� acld�K � t�-1�.� <br /> L <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 SU13JECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Recei ed b (si re): Title: Date: <br /> 197 <br /> Received by(printed name): Inspector: Inspector phone: <br /> 41) <br /> EHD 19-01 REV 03/04/15 Page 1 HM INSPECTION REPORT <br />