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SAN '�d DAQ II II Environmental Health Department <br /> C0L.IJT`o' <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Custom Design Manufacturing 248 E Kettleman Ln, Lodi September 30, 2021 <br /> Violations <br /> 1055 See below Unlisted Abandonment/Illegal Disposal/Unauthorized Treatment-Local Ordinance ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 4 HSC 25508(a)(1) Failed to electronically submit the Business Activities or Owner/Operator Identification page. <br /> OBSERVATION: The business activities and owner/operator identification page has not been annually <br /> certified/submitted as a part of the business plan. The business activities and owner/operator identification page <br /> has not been submitted since 06/19/2017. <br /> REGULATION GUIDANCE: Per H&SC 25508.2, the business owner/operator shall annually review and certify that <br /> the business plan is complete, accurate, up-to-date and in compliance with Section 11022 of Title 42 of the United <br /> States Code.An annual electronic submittal satisfies these requirements.The annual business plan shall be <br /> submitted/certified by January 15 of each calendar year and may be submitted beginning November 1 of the <br /> previous year. <br /> CORRECTIVE ACTION: This violation was corrected on site. <br /> This is a repeat violation, Class II. <br /> 5 HSC 25505(a)(1) Failed to electronically submit hazardous materials inventory for all reportable materials on site. <br /> OBSERVATION: The hazardous materials inventory has not been annually certified/submitted as a part of the <br /> business plan.The hazardous materials inventory has not been submitted since 06/17/2017. The inventory had the <br /> following issues: <br /> -the maximum daily amount for carbon dioxide was inaccurately reported as 150 cubic feet, 1,229 cubic feet was <br /> observed on site <br /> -the chemical inventory contained obsolete hazard categories <br /> REGULATION GUIDANCE: Per H&SC 25508.2, the business owner/operator shall annually review and certify that <br /> the business plan is complete, accurate, up-to-date and in compliance with Section 11022 of Title 42 of the United <br /> States Code.An annual electronic submittal satisfies these requirements.The annual business plan shall be <br /> submitted/certified by January 15 of each calendar year and may be submitted beginning November 1 of the <br /> previous year. <br /> CORRECTIVE ACTION: This violation was corrected on site. <br /> This is a repeat violation, Class II. <br /> FA0009569 PR0519732 SCO01 09/30/2021 <br /> EHD 19-01 Rev.9/16/2020 Page 2 of 5 Hazardous Materials Program OR <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 />