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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.sicehd.com <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> Facilityl �� / Facility p — Inspection <br /> Name: 7 Phone: ZD/—Z 5 _1 3 Date: f/j��IZ02v <br /> Facility CERS <br /> Address: I 662l n Ligon ID: <br /> InspectionTitle: Phone: <br /> Contact: -oj���(� �. Mang 2�9-2s3-i3�3 <br /> InspectionProgram: <br /> �L <br /> Type: 0a tilt6— lI1 9 11dad> IvAtc{rA, x�mssP/�n <br /> 7nit Given For: Consent <br /> ection ff Photos ❑ Sampling Given 8y: <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 25505, Failed to complete and electronically submit a hazardous materials business plan(V335) ❑ ❑ <br /> 25508 a 1 <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) P/ ❑ ❑ <br /> 5 HSC 25501 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) 2/ ❑ ❑ <br /> 7 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release(v34e) ❑ ❑ <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 1 ❑ ❑ ❑ <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 1 ❑ ❑ 1 ❑ <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 It,or MINOR-Notice to Comply <br /> burr' e5 has en or mon to aLnat- /1at G�� <br /> 5 f" S <br /> I l 6- -A- Vr dw eA �t, �� a rf Zai:-1 S C <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 /> Rece' d (signature): e: Date: <br /> 20 2O <br /> Re eived by(printed name): Inspector: Inspector phone: <br /> [Viam6foi, �`� A&k1 L o e A6,e,49 209--W-06 23 <br /> EHD 19-01 REV 07/28/16 Page 1 HM INSPECTION REPORT <br />