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SAN .IOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.slcehd.com EHD 19-01 REV 07/28/16 rage � / nm u�or��. i ivi� � .��.�� Violations HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT R COS Facility 1 Name: ��C.l.'Q � � �p� r '�,.(� CQ � ❑ Facility Phone: 2 Inspection Date: Facility Address: �, Z.8 � I ' � l vL �^-� � D C. ��0� � � � � zO � DERS gG, O Inspection � Contact: � � � a/ 4 Title: �e.lti�.�2 � „^ In' 44 � CE CJ Phone: ❑ Inspection 1 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site (V343) 1 Program: ❑ p{ 6 HSC 25505(a)(3) Failed to complete and/or submit a site map with all required content (V347) �j ❑ Q 7 HSC 25505(a)(3) Consent Given or: p( Consent Given By: Title: � L4 �. HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility (V350) nspection hotos ❑Sampling 9 u,r Failed to annually review and certify that the business plan is complete, accurate, and up to date (V342) ❑ ❑ CCR =California Code of Regulations HSC =Health and Safety Code CFR =Code of Federal Regulations SJO =San Joaquin County Ordinance HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel (V349) ❑ a V =Violation R =Repeat COS =Corrected on site during inspection EHD 19-01 REV 07/28/16 rage � / nm u�or��. i ivi� � .��.�� Violations V R COS 1 SJO 4432 Failed to pay annual operating fees (V851) ❑ ❑ ❑ 2 HSC 25505, 25508 a 1 Failed to complete and electronically submit a hazardous materials business plan (V335) � ❑ Q 3 HSC 25507 Failed to establish and implement a hazardous materials business plan (V334) y1( ❑ ❑ 4 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345) �( ❑ 5 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site (V343) � ❑ p{ 6 HSC 25505(a)(3) Failed to complete and/or submit a site map with all required content (V347) �j ❑ Q 7 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release Iv3ael p( ❑ Title: 8 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility (V350) � ❑ �( 9 HSC 25508.2 Failed to annually review and certify that the business plan is complete, accurate, and up to date (V342) ❑ ❑ ❑ 10 HSC 25508.1 (a -f) Failed to submit revisions to HMBP within 30 days of substantial change in operations (V346) ❑ ❑ ❑ 11 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel (V349) ❑ a 12 HSC 25505(c) Failed to have the business plan readily available to facility or EHD personnel (V850) �' ❑ ❑� 13 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program (V341) ❑ ❑ ❑ 14 HSC 25510 Failed to report actual or threatened release to the EHD and/or CaIOES Warning Center (V338) ❑ ❑ ❑ 15 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements (351) ❑ ❑ ❑ 16 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements (V352) ❑ ❑ ❑ 17 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions (V353) ❑ ❑ ❑ 18 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report (V808) ❑ ❑ ❑ 1010 See below Unlisted Administration/Documentation violation (V355) ❑ ❑ ❑ 1040 See below Unlisted Release/Leaks/Spills violation (V356) ❑ ❑ ❑ EHD 19-01 REV 07/28/16 rage � / nm u�or��. i ivi� � .��.�� SUMMARY OF VIOLATIONS CLASS I, CLASS II, or MINOR —Notice to Com I rr 0 � - �L :C � C� Zo a l �0 4 � ��.�.�. ,, �j, �- c�-e/'v� � �ev' c ..C, t o H .a o i� w i �I � � r0✓ic�� . ALL EH STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOT DATES WILL BE BI ED AT THE CURRENT HO LY RATE. T CILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. Receiv si re): Title: Date: R c ' tinted name): Inspector: Inspector phone: �l-L��q �A � / o b�i7� � .may �2-o�J qS�3 - 62 / � flT EHD 19-01 REV 07/28/16 rage � / nm u�or��. i ivi� � .��.��