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San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, Califomia95205-6232 Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sicloy.orq/ehd Hazardous Materials Program Inspection Report Facility Name: Facility Address: Date: JACK IN THE: ``34' OCKTON Aril 08 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 Owner/Operator Identification form was not complete. The Secondary Emergency Contact information has 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/, enterthe correct or updated information, and submit to the EHD for approval. This is a repeat violation, Class II. 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release. The emergency response procedures have not been submitted. 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 tc. sons, property, or the environment evacuation plans and procedures, including immediate notice, for the site mediately log into the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov/, upload thr ect or updated information, and submit to the EHD for approval. This is a repeat violation, Class ll. 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility. A training program has 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 hazardouL 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 )gram, log into the California Environmental Reporting System(CERS) at http://Gers.calepa.ca.gov/, upload the ect or updated information, and submit to the EHD for approval. s is a repeat violation, Class N. Overall Inspection Comments: Complete and submit a copy of the Return to Comp _, ign to the EHD with a state, _ documenting the corrective actions that have been or will be taken for each violation, and any supporting paperwork, by May 9, 2015. A copy of the inspection report and inspection photos was provided to Sandra Deli. Please be aware as of January 1, 2013, all businesses were required to submit all hazardous materials information online to the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov. Be sure to include your hazardous material activity in the Businesses Activities section in CERS in addition to any other relevant Received by Inspector: Phone: Date: (initial): �(� ROBERT LOPEZ, HM Specialist II (209) 953-6214 04/08/2015 Page 2 of 3