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*. 1-01 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, Califomia 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sicehd.com <br /> R.DOUSIMATERIALS PROGRAM`INSPECTIONJRE W <br /> Facility Facility n Inspection <br /> Name: O �hI`G�'�lI Phona: -d 9— 30^�� Date: (9�Z�lZd <br /> Facility �/ 6�'a-/�tl/� ,yf tCERS <br /> o: <br /> Address: ` Q�� ID: <br /> n a3ern M� rrls0u� Ttie: stoke >Vl f�n6A' �? �°ae�0-930-111 <br /> Inspection � �c Pro9a �!/t'GO7 <br /> Co99��enl Given FV <br /> Consent <br /> Inspection �7Photos D Sampling Given By: 5 e rj Q L(l� <br /> CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations <br /> V=Violation R=Repeat COS=Corrected on site during inspection <br /> A Violations. „.:;, .; ,V LR;; COS? <br /> 1 HSC 25507 Failed to establish and implement a hazardous materials business plan(V334) ❑ ❑ <br /> 2 HSC 25508(a)(1) Failed to electronically submit a business plan(V335) ❑ ❑ <br /> 3 HSC 25508.2 Failed to annually review and certify that the business plan is complete,accurate,and up to date(V342) ❑ ❑ <br /> 4 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program(V341) ❑ ❑ ❑ <br /> 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center(V338) ❑ ❑ ❑ <br /> 6 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page(V345) ❑ ❑ <br /> 7 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site(V343) ❑ ❑ <br /> 8 HSC 25508.1(a)-(e) Failed to submit revisions to HMBP within 30 days of change in business info or inventory(V346) ❑ ❑ ❑ <br /> 9 HSC 25508.1(1) Failed to submit revisions to HMBP within 30 days of substantial change in operations(`344) ❑ ❑ ❑ <br /> 10 HSC 25505(a)(2) Failed to complete and/or submit a site map with all required content(V347) ❑ ❑ <br /> 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release Nun ❑ ❑ <br /> 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility(V350) ❑ ❑ <br /> 13 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel(V349) ❑ ❑ <br /> 14 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements(351) ❑ ❑ ❑ <br /> 15 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements(V352) ❑ ❑ ❑ <br /> 16 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions(V353) ❑ o ❑ <br /> 17 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report(V808) ❑ ❑ ❑ <br /> 1010 See below Unlisted Administration/Documentation violation(V355) ❑ ❑ ❑ <br /> 1040 See below Unlisted Release/Leaks/Spills violation(V356) n c ❑ <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS II,or MINOR—Notice to Comply <br /> A cu.lr6ox ioxi ORew2`e- a 6 Lt10 ) <br /> hC07 b 04-01 � s c„ 0 <br /> ALL END STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by(signature): Title: Date: / s <br /> Received by(printed name): Inspector. Inspector phone: <br /> Ni6l1 LveAf-ef 209—W-0623 <br /> EHD 19-01 EV3/15 Page 1 HM INSPECTION REPORT <br />