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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 /> COUNTRY CLUB MOBIL CIRCLE K 2575 COUNTRY CLUB BLVD, STOCKTON August 30, 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. The following elements are missing or incorrect: <br /> -The loading area for carbon dioxide was missing from the site map <br /> -Internal roads were not included on the site map(no internal roads) <br /> -Two fire extinguishers listed inside the store on the site map were not observed during the inspection (center north <br /> of store, south corner of store) <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 /> 12 HSC 25505(c)Failed to have the HMBP readily available to facility or EHD personnel. <br /> OBSERVATION: Facility could not provide the current Emergency Response Plan upon request. An outdated <br /> (2018)copy of the emergency contingency plan was observed on site. <br /> REGULATION GUIDANCE: The emergency response plans and procedures,the inventory of information required <br /> by this article, and the site map required by this section shall be readily available to personnel of the business or the <br /> unified program facility with responsibilities for emergency response or training pursuant to this section. <br /> CORRECTIVE ACTION: Immediately make arrangements to have the business plan readily available for review. <br /> This is a minor violation. <br /> Overall Inspection Comments: <br /> Conducted a Hazardous Materials Business Plan (HMBP) inspection. There were two violations during the <br /> inspection. Complete and submit a copy of the Return to Compliance Certification form to the EHD with a <br /> statement documenting the corrective actions that have been or will be taken for each violation, and any <br /> supporting paperwork, by September 30, 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: Return to Compliance certification, flyer for free CUPA classes, site map guidance <br /> FA0006439 PR0519887 SCO01 08/30/2021 <br /> EHD 19-01 Rev.9/16/2020 Page 2 of 3 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 />