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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd/unitiii.htmi <br />HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br />Facility <br />Name: <br />Facility <br />Address: Wlo� <br />9�-j <br />Inspection <br />Date: <br />Facility <br />Contact: <br />Title: <br />Phone: <br />Inspection <br />Type: <br />outine El Follow up ❑Complaint— ID#: ❑ Other: <br />(Authority HSC 25508) <br />Consent for. D Inspection D Sampling ❑ Photos Granted by: Title: <br />VIOLATIONS <br /># Ct <br />HSC = California Health and Satety Code CCR = California Code of Re ulations <br />C2 M n C1 = Class 1 violation; C2 = Class 2 violation- M = Minor violation <br />1 <br />2 <br />3 <br />) Failed to maintain a complete copy of the business plan on site <br />)(1) Failed to complete and submit the Business Owner/Operator Identification information [HSC25509] <br />a)(2) Failed to complete and submit the Hazardous Materials — Chemical description information [HSC 255091 <br />22731jrgRr. <br />4 <br />5 <br />a)(3) Failed to complete and submit an Annotated Site map [HSC 25509] <br />Failed to include emergency response procedures for a release or threatened release of hazardous materials <br />HSC 25504 b <br />6 <br />Failed to include a training program that includes at minimum: (1) safe handling of hazardous materials; (2) <br />CCR 2732(a) procedure for coordination with local emergency response organizations; (3) use of emergency equipment <br />and supplies; and 4 emergency response procedures FHSC 25504 c <br />7 <br />6 <br />CCR 2732(b) Failed to provide initial and/or refresher training to appropriate personnel [HSC 25504(c)] <br />CCR 2703 Failed to verbally report a release or threatened release immediately to the Environml Health Department <br />EHD and/or the Califomia Emergency Management Agency CaIEMA HSC 255072 <br />g <br />HSC 25505(b) Failed to update and submit revisions to the business plan when substantial changes occur <br />999 <br />Other: See attached "Continuation — Official Inspection Report" for violation(s) not listed above. <br />SUMMARY OF VIOLATIONS <br />CLASS I, CLASS II, or MINOR -Notice to Comply) <br />vi ir-w <br />e� noL ue&�4b: I R)n <br />S <br />A Ur 6L r <br />ALL EHD 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 />Inspect Phone: <br />fv 20q-6M-ZO <br />Reoei"d by Tlle: <br />EHD 18-01 Page 1 HM INSPECTION REPORT <br />