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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:wwvv.sjcehd.com <br /> SPECTION REPO1 <br /> HAA ©l1S MATER L SPR <br /> Facility <br /> Inspectio <br /> Facility Phone <br /> Name: CERB <br /> Facility ID: <br /> Address: <br /> Till e• on _,•��_ <br /> Inspection W <br /> Contact <br /> Inspection M�P Frog <br /> Type: yy II 1 <br /> Consent Given For. Consent <br /> Inspection Pfiotos ❑Sampling Given By: <br /> C R=California C e of Regulations HSC=Health and Salary Code CFV=Violation ederalR=eRep <br /> ela <br /> t <br /> 5 COS=Corrected on site during inspeOR <br /> ction <br /> j2 [GgS <br /> 1 HSC 25507 Failed to establish and implement a hazardous materials business plan(V334) <br /> ❑ ❑ ❑ <br /> OOelectronically ❑ ❑ ❑ <br /> 2 HSC 25508 a 1 Failed to 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 HBC 25505.1 Failed to notify property owner that facility is subject to and in compllance with the HMBP program(V341) ❑ ❑ ❑ <br /> 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CaIOES Warning Center(V338)- <br /> ❑ ❑ ❑ <br /> 6 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operetor Identification pi '-!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 /> ❑ ❑ <br /> 9 HSC 25506.1(1) Failed to submit revisions to HMBP within 30 days of substantial change in operations(V344) <br /> ❑ ❑ <br /> OO n ❑ ❑ <br /> 10 HBC 25505 a 2 Failed to complete and/or submit a site map with all required content 347) <br /> 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release ma) ❑ ❑ ❑ <br /> ( X ) ❑ ❑ ❑ <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 /> ❑ ❑ <br /> 14 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handier exemption requirements(351) ❑ ❑ ❑ <br /> 15 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements(V352 <br /> ❑ ❑ ❑ <br /> 16 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions(V353) ❑ ❑ ❑ <br /> 17 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report(V808) <br /> ❑ ❑ ❑ <br /> 1010 See below <br /> Unlisted Administratlon/Documentalion violation(V355) ❑ ❑ ❑ <br /> 1040 See below Unlisted Releasell-eaks/Spills violation(V356) <br /> SUMMARY OF VIOLATIONS <br /> __,(CLABS/,:CLASSIIior_MINOR, Noticeto,Coingl <br /> ma <br /> F3:i:i:ii:: o AT THE CURRENT <br /> RLY <br /> ALL F MA T=HD STAFF TIME ASSOA153:45is N111111515 DEW e <br /> HIS FACILITY IS SUBJECT TO REINSPECTION AT ANYTIME AT END'S CURRENT HOURLY DRATE.re. <br /> Received by(signature): <br /> Title: Date: ' <br /> zoDUC—t S t)f' (O I /s <br /> Ins action Inspector phone: <br /> R ` ved by(printed na.. <br /> JiM SANC fill,eZ Page1� HM INSPECTION REPORT <br /> END 19-01 REV 04/23!15 <br />