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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 />EHD 19-01 REV 07/28/16 rage i
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<br />HAZARDOUS MATERIALS PROGRAM
<br />INSPECTION
<br />REPORT
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<br />Inspection
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<br />Failed to establish and implement a hazardous materials business plan (V334)
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<br />Facility
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<br />Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345)
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<br />Failed to annually review and certifij that the business plan is complete, accurate, and up to date (V342)
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<br />Consent Given For:
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<br />❑Sampling
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<br />HSC 25505(c)
<br />CCR =California Code of Regulations
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<br />HSC =Health and Safety Code CFR =Code of
<br />Federal Regulations
<br />SJO =San
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<br />County Ordinance
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<br />V =Violation
<br />R =Repeat
<br />COS =Corrected on
<br />site during inspection
<br />EHD 19-01 REV 07/28/16 rage i
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<br />Violations
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<br />Failed to pay annual operating fees (V851)
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<br />2
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<br />25508 a 1
<br />Failed to complete and electronically submit a hazardous materials business plan (V335)
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<br />3
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<br />Failed to establish and implement a hazardous materials business plan (V334)
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<br />4
<br />HSC 25508(a)(1)
<br />Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345)
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<br />5
<br />HSC 25506(a)
<br />Failed to complete and/or submit hazardous materials inventory for all reportable materials on site (V343)
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<br />6
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<br />Failed to complete and/or submit a site map with all required content (V347)
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<br />HSC 25505(a)(3)
<br />Failed to establish and/or submit emergency response procedures for a release or threatened release Ivaaal
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<br />HSC 25505(a)(4)
<br />Failed to submit a training program or program is not reasonable or adequate for facility (V350)
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<br />Failed to annually review and certifij that the business plan is complete, accurate, and up to date (V342)
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<br />10
<br />HSC 25508.1 (a -f)
<br />Failed to submit revisions to HMBP within 30 days of substantial change in operations (V346}
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<br />HSC 25505(a)(4)
<br />Failed to provide or document initial and/or refresher training to appropriate personnel (V349)
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<br />12
<br />HSC 25505(c)
<br />Failed to have the business plan readily available to facility or EHD personnel (V850)
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<br />13
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<br />Failed to notify property owner that facility is subject to and in compliance with the HMBP program (V341)
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<br />14
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<br />Failed to report actual or threatened release to the EHD and/or CaIOES Warning Center (V338)
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<br />15
<br />HSC 25507.1
<br />Failed to submit emergency response plan when not meeting Ag handler exemption requirements (351)
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<br />16
<br />HSC 25507.1
<br />Failed to submit training program when not meeting Ag handler exemption requirements (V352)
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<br />17
<br />HSC 25507.2
<br />Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions (V353)
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<br />18
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<br />Failed to submit a written response within 30 days of receiving an inspection report (V808)
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<br />1010
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<br />Unlisted Administration/Documentation violation (V355)
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<br />1040
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<br />Unlisted Release/Leaks/Spills violation (V356)
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<br />EHD 19-01 REV 07/28/16 rage i
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<br />SUMMARY OF VIOLATIONS
<br />CLASS I, CLASS II, or MINOR —Notice to Com I
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<br />ALL EHD STAFliF TIME ASSOCIATED
<br />WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE
<br />CURRENT HOURLY RATE.
<br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S
<br />CURRENT
<br />HOURLY RATE.
<br />Title:
<br />Date:
<br />Received by (signature): _ �
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<br />Received
<br />by (pnn�j`ed name):
<br />Inspector:
<br />In/s�pector phcone: ��t
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<br />EHD 19-01 REV 07/28/16 rage i
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