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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209) 468-3420 Fax:(209)468-3433 Web:www.sicehd.com <br /> 1 S MATERIALS PROGRAM INSPECTION REPORT F <br /> FacilityFacility Inspection/ �k /L� <br /> Name: (�( (� G{ / C� Phone: �- �"���1.� Date. (p <br /> Facility // // EPA _ CERS <br /> Address: 5� �. !�� l ID: ID: <br /> Facility Contact Contact during inspection,if <br /> Contact: Phone: different from facility contact: <br /> inspectony� Program: <br /> V <br /> Type: K <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 /> Violations ,V R: COS <br /> 1 HSC 25507(a) Failed to establish and implement a hazardous materials business plan(V334) ❑ ❑ <br /> 2 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program(V341) ❑ ❑ ❑ <br /> 3 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Wanting Center(V338) ❑ o ❑ <br /> 4 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site(V343) ❑ ❑ <br /> 5 HSC 25508.2 Failed to submit hazardous materials business plan annually(V342) ❑ ❑ ❑ <br /> 6 HSC 25508.1 Failed to submit revisions to HMBP within 30 days of change in inventory or operations(V346) ❑ ❑ ❑ <br /> 7 HSC 25505(a)(2) Failed to complete and/or submit a site map(V347) ❑ ❑ <br /> 8 HSC 25505(a)(3) Failed to include emergency response procedures for a release or threatened release(V348) ❑ ❑ ❑ <br /> 9 HSC 25505(a)(4) No training program or program is not reasonable or adequate for facility(V350) ❑ ❑ ❑ <br /> 10 HSC 25505(a)(4) Failed to provide initial and/or refresher training to appropriate personnel(V349) ❑ ❑ ❑ <br /> 11 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) ❑ ❑ ° <br /> ri <br /> SUMMARY OF VIOLATIONS <br /> CLASS 1,CLASS II,or MINOR—Notice to Comply <br /> VA 4 <br /> f C _ 1 , l <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 /> Rece ed y: Title: Date: <br /> 87� l- <br /> Insp .t Title Dat//e: <br /> Pal ( Vn S eclif - /4 <br /> EHD 19-01 REV 05/22/14 Page 1 HM INSPECTION REPORT <br />