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S A N J 0 A Q I I I Irl Environmental Health Department <br /> CCUNT <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> CHEVRON STATION#94275* 2905 W BENJAMIN HOLT DR, STOCKTON August 26,2021 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 6 HSC 25505(a)(2) Failed to electronically submit a site map with all required content. <br /> OBSERVATION: The site map is incomplete. Internal roads are missing from site map. <br /> REGULATION GUIDANCE:A site map shall contain a north orientation, loading areas, internal roads, adjacent <br /> streets, storm and sewer drains, access and exit points, emergency shutoffs, evacuation staging areas, hazardous <br /> material handling and storage areas, and emergency response equipment. <br /> If a site map element is not applicable for your facility then list it on the map and label as"NA". <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov/, upload the correct or updated information, and submit to the EHD for approval. <br /> This is a minor violation. <br /> Overall Inspection Comments: <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by 9/26/2021. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate <br /> ($152). To schedule an appointment, please call (209)468-3420. <br /> Documents provided during inspection: Return to Compliance Certification, Flyer for Free CUPA Classes, and <br /> site map guidance <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: August 26, 2021 Inspector: Inspector Phone: <br /> Printed Name and Title: LYDIA BAKER, REHS (209)616-3046 <br /> Emailed to Kenisha Jenkins, Operator <br /> FA0003712 PR0519641 SCO01 08/26/2021 <br /> EHD 19-01 Rev.9/16/2020 Page 2 of 2 Hazardous Materials Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />