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SI Environmental Health Department — COL) NTY— � r Greatness grows leer: . Hazardous Materials Program Inspection Report Facility Name: Facility Phone: Date: MIDGLEYS PUBLIC HOUSE (209)474-7700 December 03, 2019 Facility Address: CERS ID: 296 LINCOLN CENTER , STOCKTON, CA 95207 0 Inspection Contact: Title: Phone: Carrie Booth Kitchen Manager (209)953-6214 Inspection Type: Program: ROUTINE INSPECTION - Operating Permit 11919 - HMBP-0O2 Only Food Facility Consent For: I Consent Given By: 0 Inspection 0 Photos ❑ Samples I Carrie Booth, Kitchen Manager 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 Win 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 Abandon ment/IIlegal Disposal/Unauthorized Treatment violation ❑V ❑R ❑COS FA0006681 PR0545066 SCO01 12/03/2019 EHD 19-01 Rev.9/20/2019 Page 1 of 5 Hazardous Materials Program OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com