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AN <br />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 />EHD 19-01 REV 07/28/16 <br />Page 1 <br />HM INSPECTION REPORT <br />HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br />Facility�+� I <br />Name: Go14eN% <br />1 1 1l ISI <br />N ue—,r T " �Ol 11 C-� fja� <br />Phone 704 -15-1-21J-5-0 <br />Data .3113 /om <br />Addrress 1810 F ,<- <br />Id AUe• SS loc �T�t1 cA RJ Zai ` J <br />CERS ) <br />ID: /I.0 4 <br />Inspection <br />Contact L <br />/N <br />Title: ���/ <br />4� 0146- �. <br />Phone: <br />�9 qJr/ --tfSO <br />Inspection <br />Type: <br />.. <br />Program: <br />Z <br />Cc sent Given For. Consent / <br />Inspection hotos ❑ Sampling Given By: S C% <br />CCR = California ode of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations SJO = San Joaquin County Ordinance <br />V = Violation R = Repeat COS = Corrected on site during inspection <br />Violations V R COS <br />1 SJO 4432 <br />Failed to pay annual operating fees (V851) ❑ ❑ ❑ <br />2 HSC 25505, <br />25508 a1 <br />Failed to complete and electronically submit a hazardous materials business plan (V335) X ❑ ❑ <br />3 HSC 25507 <br />Failed to establish and implement a hazardous materials business plan (V334) ,'{( ❑ ❑ <br />4 HSC 25508(a)(1) <br />Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345) i( ❑ ❑ <br />5 HSC 25506(a) <br />Failed to complete and/or submit hazardous materials inventory for all reportable materials on site (V343) X ❑ ❑ <br />6 HSC 25505(x)(3) <br />Failed to complete and/or submit a site map with all required content (V347) x ❑ ❑ <br />7 HSC 25505(a)(3) <br />Failed to establish and/or submit emergency response procedures for a release or threatened release "a) j� ❑ ❑ <br />8 HSC 25505(a)(4) <br />Failed to submit a training program or program is not reasonable or adequate for facility (V350) ❑ ❑ <br />9 HSC 25508.2 <br />Failed to annually review and certify that the business plan is complete, accurate, and up to date (V342) ❑ ❑ <br />10 HSC 25508.1(a-1) <br />Failed to submit revisions to HMBP within 30 days of substantial change in operations (V346) ❑ ❑ ❑ <br />11 HSC 25505(a)(4) <br />Failed to provide or document initial and/or refresher training to appropriate personnel (V349) ❑ ❑ <br />12 HSC 25505(c) <br />Failed to have the business plan readily available to facility or EHD personnel (V850) ,(' ❑ ❑ <br />13 HSC 25505.1 <br />Failed to notify property owner that facility is subject to and in compliance with the HMBP program (V341) ❑ ❑ ❑ <br />14 HSC 25510 <br />Failed to report actual or threatened release to the EHD and/or CalOES Warning Center (V338) ❑ ❑ ❑ <br />15 HSC 25507.1 <br />Failed to submit emergency response plan when not meeting Ag handier exemption requirements (351) ❑ ❑ ❑ <br />16 HSC 25507.1 <br />Failed to submit training program when not meeting Ag handler exemption requirements (V352) ❑ ❑ ❑ <br />17 HSC 255072 <br />Failed to establish and Implement a HMBP when not meeting remote unstaffed facility exemptions (V353) ❑ ❑ ❑ <br />18 HSC 25511 <br />Failed to submit a written response within 30 days of receiving an inspection report (V808) ❑ ❑ ❑ <br />1010 See below <br />Unlisted Administmtion/Documentation violation (V355) ❑ ❑ ❑ <br />1040 See below <br />Unlisted Release/Leaks/Spills violation (V356) ❑ ❑ ❑ <br />SUMMARY OF VIOLATIONS <br />CLASS 1, CLASS II, or MINOR —. Notice to Comply <br />Sou,% X 2.O <br />c SOS 9r <br />1 <br />AV A I S' csL-L11} f O K G`k L ¢=% to l S �Q+1rs <br />� d+c.,%< a ✓csir eld ¢H h Dido 090'4 / 1. coo" <br />ALL EHO 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): <br />Title: <br />M� <br />Date: <br />3�l'�118 <br />Received by me): <br />Inspector. <br />Inspector phone: <br />EHD 19-01 REV 07/28/16 <br />Page 1 <br />HM INSPECTION REPORT <br />