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N ,�O I A� Environmental Health Department <br /> C 0 U i�7 Y I�i ,j Q �f' ['' <br /> Ck�, -f /©f77 < Jy <br /> Hazardous Materials Program Inspection Report <br /> Facility Name:. Facility Phone: Date: <br /> Facility Address: GERS ID: <br /> 2.34 7 z (o �-�-- <br /> Inspe tion CTite: Phone: <br /> c- "G'4 <br /> — —/S Q <br /> ection Type: <br /> Program: <br /> Consent For: Consentfjeven <br /> ns ection AFhotoS ElSam les �- -V. <br /> CCR=Title 19 California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations <br /> V=Violation R=Repeat violation COS=Corrected on site during inspection <br /> Violations <br /> 1 SJO 4432 Failed to pay annual operating fees o V o R ❑COS <br /> 2 HSC 25505,25508(a) Failed to initially complete and electronically submit a HMBP ,14(V ❑R NOS <br /> (1) <br /> 3 HSC 25507 Failed to establish and implement a hazardous materials business plan XV o R XCOS <br /> 4 HSC 25508(a)(1) Failed to electronically submit the Business Activities or Owner/Operator Identification page o R ACOS <br /> 5 HSC 25505(a)(1) Failed to electronically submit hazardous materials inventory for all reportable materials on site AV o R ACOS <br /> 6 HSC 25505(a)(2) Failed to electronically submit a site map with all required content .X•V o R o COS <br /> 7 HSC 25505(a)(3) Failed to electronically submit an adequate ER procedures for a release or threatened release XV o R FLfGOS <br /> 8 HSC 25505(a)(4) Failed to establish and electronically submit a reasonable or an adequate training program &V o R (COS /A <br /> 9 HSC 25508.2 Failed to annually review and certify that the HMBP is complete and accurate by the due date <br /> 10 HSC 25508.1(a)-(f) Failed to electronically update the HMBP within 30 days of substantial change in operations o V o R o COS <br /> 11 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel )<V o R o COS <br /> 12 HSC 25505(c) Failed to have the HMBP readily available to facility or EHD personnel )IN o R a COS <br /> 13 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program o V o R o COS <br /> 14 HSC 25505.1 Business on leased property failed to provide copy of HMBP w/in 5 days of request by property owner o V o R o COS <br /> 15 HSC 25510(a) Failed to report actual or threatened release to the EHD and/or CalOES Warning Center o V o R o COS <br /> 16 HSC 25507.1 Failed to electronically submit ER plan when not meeting Ag handier exemption requirements o V o R o COS <br /> 17 HSC 25507.1 Failed to Actronically submit training program when not meeting Ag handler exemption requirements o V o R o COS <br /> 18 HSC 25505,25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions o V o R o COS <br /> 19 HSC 25404.1.2 Failed to submit a certification and written response within 30 days for minor violations o V o R o COS <br /> 20 HSC 25507.1(a)(2),T19 Failure of Ag handler to post adequate warning signs to meet exemption requirements o V o R o COS <br /> 2671 <br /> 1010 See below Unlisted Administration/Documentation violation o V o R o COS <br /> 1020 See below Unlisted Training violation o V o R o COS <br /> 1030 See below Unlisted Operations/Maintenance violation o V o R o COS <br /> 1040 See below Unlisted Release/Leaks/Spills violation o V o R o COS <br /> 1045 See below Unlisted Release/Leaks/Spills-Local Ordinance o V o R o COS <br /> 1050 See below Unlisted Abandon menUlllegal Disposal/Unauthorized Treatment violation o V o R o COS <br /> 1055 See below Unlisted Abandon menUlllegal Disposal/Unauthorized Treatment-Local Ordinance o V o R o COS <br /> FA0009065 PRO519356 SCO03 02/01/2021 <br /> EHD 19-01 Rev.9/16/2020 Page 1 of 2 Hazardous Materials Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />