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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 . s0cehd . com <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> Facilit Facility 0 Inspection <br /> y Phone : 209 . 4 <br /> � 9 ' � � O 7 �ij (/ Date : j 3/sD� I <br /> Name: G , A r T. <br /> Facility CERS <br /> uQv ID :Address: / U �1� <br /> Inspection Title : • J� Phone: <br /> Contact: ��� G 0 / l �ljJ/ 7,,fe ''�'!Yt �il � t� iAtO 6 ) Q — ,(;O 7 — � D <br /> InspectionProgram: <br /> Type: gDCGt/ 11 {i <br /> Cogg eat Given For: // consent /t /�� ^ ,t u ��l <br /> �/fnspection m�Photos ❑ Sampling Given By: A G / V <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) 4� ❑ ❑ <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) q/ ❑ ❑ <br /> 5 HSC 25506 (a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site (V343) d ❑ ❑ <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 (vs4at d ❑ ❑ <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) Q/ ❑ ❑ <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 CaIOES Warning Center (V338) ❑ ❑ ❑ <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 (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 II , or MINOR — Notice to Comply <br /> ge ELI A fnaztli 7' 0740ft ee h,%el)4 ( c 4 f5 1 1 PPLAd VA 51rZ`e r) �' bus i2C <br /> �Sme ap at' 6e D �u6�� at- �I 2a f��.��e 6'1a gu slile 3:5 l a,& <br /> IIm ►2 �h � �A1� � 6,n nvtsonm ?1ztt �e %ea6 IIji S ' rem, C�lzS <br /> ab'oxIIn0, fe, Ity a `lans 0 <yd iix `yt e /zlo6¢ � �� ;ie <br /> IV Quad on s ' e r <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 /> Received by (signature) : Title: Date : <br /> No ti rt >% �n covid ' I TfeA ney, I opeiA ,; 2 0Z <br /> ReceiveAy (printed name) : Inspector: Inspector phone : <br /> rU/ 10 <br /> EHD 19-01 REV 07/28/16 Page 1 HM INSPECTION REPORT <br />