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San Joaquin County ~ Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.s4gov.org/ehd 'Ratar oG2 ate"rlaa rog"ram nspectIon Rep' Facility Name: Facility Address: Date: COST PLUS WORLD MARKET 3610 S AIRPORT WAY, STOCKTON Aril 02 2015 SUMMARY OF VIOLATIONS (CLASS I,CLASS II,or MINOR-Notice to Comply) Item# Remarks 6 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page. The Business Activities form does not indicate that the business is a hazardous waste generator and the EPA ID No. has not been identified. 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. The Business Owner/Operator Identification form was not complete. The name and title of the Document Signer and Document Preparer and the Locally Collected Information have not been completed. This information must be current and submitted as part of the business plan. 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 Class II violation. 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release. The emergency response procedures were lacking or inadequate. Procedures for Immediate notification the Environmental Health Department(EHD and for the mitigation of a release or threatened release were not in the plan submittal. 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 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. 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility. A training program was lacking or insufficient. Training to address the presence of hazardous materials at this facility have not been submitted. Training programs for all employees and annual training, including refresher courses, shall include safety procedures for the event of a release or threatened release of a hazardous material, including, but not limited to, familiarity with the facility's emergency response plans and procedures. These training programs may take into consideration of each employee. Immediately prepare or update the facility's training program, log into the California Environmental Reporting System (CERS)at http://cers.Galepa.ca.gov/, upload the correct or updated information, and submit to the EHD for approval. This is a Class II violation. Overall Inspection Comments: Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement documenting the corrective actions that have been or will be taken for each violation, and any supporting paperwork, by May 2, 2015. Received by Inspector: Phone: Date: (initial): ROBERT LOPEZ, HM Specialist II (209) 953-6214 04/02/2015 Page 2 of 3