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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 /> Facility Facility 7 9 _ Inspection j2� �1d1 <br /> Name: r+ C 6 L Ori Gi iLG L JYI dt /1 Phone : �U — 77 / " l:�Sf� Date : <br /> CERS <br /> Facility ) 7 ID: <br /> Address: / 3 y ID: <br /> Inspection / J � Title: �y Phones p <br /> Gn L '7/ U(i Z � � � 5 <br /> Inspection /� / Program : / <br /> Type: R p;,r t ne X la /I �Zl6 i2lL / <br /> CoiAent Given For: Consent <br /> Inspection ePhotos ❑ Sampling Given By: 11A ( � f C' e <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) ❑ ❑ ❑ <br /> 5 HSC 25506 (a) 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) ❑ ❑ ❑ <br /> 7 HSC 25505 (a) (3) Failed to establish and/or submit emergency response procedures for a release or threatened release (V348) ❑ ❑ ❑ <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 (a4) 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 /> r12HSC 25505(c) Failed to have the business plan readily available to facility or EHD personnel (V850) ❑HSC 25505. 1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program (V341 ) ❑ ❑ ❑ <br /> HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center (V338) ❑HSC 25507. 1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements (351 ) ❑HSC 25507 . 1 Failed to submit training program when not meeting Ag handler exemption requirements (V352) ❑ ❑ ❑ <br /> 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 (V808) ❑ ❑ ❑ <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 11 , or MINOR - Notice to Comply <br /> q00 e7vop PARe tan alL 5j %?, e u5erd foil /yerAtr � Quid <br /> t�� �6�a Qua�nzit �f^ X00 `�0>2 e� � n2 tiV .� �� 5 <br /> no }o `n d meai:1/)V) <br /> t11,� 6� Out a �-e�iGi p✓G� 5 %� � 5 n p � <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 EHUS CURRENT HOURLY RATE . <br /> Re d by (signature) Title : Date : <br /> MA &IA ( ;rM (n nA RTAI62 <br /> Received by (printed name) : Inspector: Inspector phone: <br /> MjTaA '3P A LZ 'i—i/p\ <br /> EHD 19=01 REV 07/28/16 Page 1 HM INSPECTION REPORT <br />