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SAN a U A Q U I N Environmental Health Department COUNTY 1 . . Hazardous Materials Program Inspection Report Facility Name : Facility Phone: Date : M SUSHI BISTRO (209 ) 400 -7505 December 31 , 2019 Facility Address: CERS ID: 212 S SCHOOL ST, LODI , CA 95240 0 Inspection Contact: Title: Phone: Minh Nguyen Owner (209 ) 406 -5533 Inspection Type: Program : ROUTINE INSPECTION - Operating Permit 11919 - HMBP - 0O2 Only Food Facility Consent For: I Consent Given By: El Inspection Z Photos ❑ Sample Minh Nguyen , Owner CCR = Title 19 California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations V = Violation R = Repeat violation COS = Corrected on site during inspection Violations 1 SJO 4432 Failed to pay annual operating fees ❑ V ❑ R ❑ COS 2 HSC 25505, 25508(a) Failed to complete and electronically submit a hazardous materials business plan ■ V ❑ R ❑ COS (1 ) 3 HSC 25507 Failed to establish and implement a hazardous materials business plan ■ V ❑ R ❑ COS 4 HSC 25508(a) (1 ) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page ■ V ❑ R ❑ COS 5 HSC 25505(a) (1 ) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site ■ V ❑ R ❑ COS 6 HSC 25505(a) (2) Failed to complete and/or submit a site map with all required content ■ V ❑ R ❑ COS 7 HSC 25505(a) (3) Failed to establish and/or submit emergency response procedures for a release or threatened release ■ V ❑ R ❑ COS 8 HSC 25505(a) (4) Failed to submit a training program or program is not reasonable or adequate for facility ■ V ❑ R ❑ COS 9 HSC 25508(a) (1 ) Failed to annually review and certify that the business plan is complete , accurate, and up to date ■ V ❑ R ❑ COS 10 HSC 25508. 1 (a)-(f) Failed to submit revisions to business plan within 30 days of substantial change in operations ❑ V ❑ R ❑ COS 11 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel ■ V ❑ R ❑ COS 12 HSC 25505(c) Failed to have the business plan readily available to facility or EHD personnel ■ V ❑ R ❑ COS 13 HSC 25505. 1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program ❑ V ❑ R ❑ COS 14 HSC 25505. 1 Business on leased property failed to provide copy of HMBP Min 5 days of request by property owner ❑ V ❑ R ❑ COS 15 HSC 25510(a) Failed to report actual or threatened release to the EHD and/or CalOES Warning Center ❑ V ❑ R ❑ COS 16 HSC 25507. 1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements ❑ V ❑ R ❑ COS 17 HSC 25507. 1 Failed to submit training program when not meeting Ag handler exemption requirements ❑ V ❑ R ❑ COS 18 HSC 25505, 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions ❑ V ❑ R ❑ COS 19 HSC 25404. 1 .2 Failed to submit a certification and written response within 30 days for minor violations ❑ V ❑ R ❑ COS 20 HSC 25507. 1 (a)(2) Failure of Ag handler to post adequate warning signs to meet exemption requirements ❑ V ❑ R ❑ COS 1010 See below Unlisted Administration/Documentation violation ❑ V ❑ R ❑ COS 1020 See below Unlisted Training violation ❑ V ❑ R ❑ COS 1030 See below Unlisted Operations/Maintenance violation ❑ V ❑ R ❑ COS 1040 See below Unlisted Release/Leaks/Spills violation ❑ V ❑ R ❑ COS 1045 See below Unlisted Release/Leaks/Spills - Local Ordinance ❑ V ❑ R ❑ COS 1050 See below Unlisted Abandonment/Illegal Disposal/Unauthorized Treatment violation ❑ V ❑ R ❑ COS FA0000692 PR0543792 SC001 12/31 /2019 EHD 19-01 Rev, 9/20/2019 Page 1 of 5 Hazardous Materials Program OIR 1868 E . Hazelton Avenue I Stockton , California 952051 T 209 468-3420 1 F 209 464-0138 1 www. sjcehd . com