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S0 JOA U 1 Environmental Health Department Hazardous Materials Program Inspection Report Facility Name: Facility Address: Date: BLACK BEAR DINER-LODI 2347 W KETTLEMAN LN, LODI May 06, 2022 SUMMARY OF VIOLATIONS (CLASS I,CLASS II,or MINOR-Notice to Comply) Item# Remarks 4 HSC 25508(a)(1) Failed to electronically submit the Business Activities or Owner/Operator Identification page. OBSERVATION: The Business Owner/Operator Identification form was not complete. Business owner, emergency primary contact, secondary emergency contact, and environmental contact information are all outdated. Update the Owner operator identification page information. REGULATION GUIDANCE: This information must be current and submitted as part of the business plan. CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at http://cers.calepa.ca.gov/, enter the correct or updated information, and submit to the EHD for approval. This is a minor violation. 7 HSC 25505(a)(3) Failed to electronically submit an adequate ER procedures for a release or threatened release. OBSERVATION: The emergency response(ER)procedures were not complete. The business name changed from Cocos to Black Bear Diner. Section E3 did not list the location of the evacuation staging area. REGULATION GUIDANCE:A business plan shall include the following emergency response procedures for a release or threatened release of hazardous materials, including, but not limited to,the following: -immediate notification of local emergency personnel and the Environmental Health Department(EHD) -procedures for the mitigation of a release or threatened release to minimize any potential harm or damage to persons, property, or the environment -evacuation plans and procedures, including immediate notice,for the site CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at http://cers.calepa.ca.gov/, upload the correct or updated information, and submit to the EHD for approval. This is a Class II violation. 9 HSC 25508.2 Failed to annually review and certify that the HMBP is complete and accurate by the due date. OBSERVATION: The business plan information has not been reviewed and resubmitted in the California Environmental Reporting System (CERS)annually by the due date, January 15.The business plan was not submitted for the years of 2019, 2020, 2021, and 2022. REGULATION GUIDANCE: The hazardous materials inventory shall be submitted by January 15 of each calendar year and may be submitted beginning November 1 of the previous year. CORRECTIVE ACTION: Immediately log into the CERS at http://cers.calepa.ca.gov/, enter the correct or updated information, and submit to the EHD for approval. This is a minor violation. FA0007134 PR0535248 SCO01 05/06/2022 EHD 19-01 Rev.12/06/2021 Page 2 of 4 Hazardous Materials Program OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD