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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.sigov.org/ehd <br />Hazardous Materials Program Inspection Report <br />Facility .Nama: <br />Facility Address: <br />Date: <br />Costco Wholesale #210 <br />17880 W Schulte Rd, Tracy <br />June 21.2017 <br />SUMMARY OF VIOLATIONS <br />(CLASS I. CLASS Ii, or MINOR - Notice to Comply) <br />Item Y <br />Remarks <br />6 <br />HSC 25505(a)(2) Failed to complete and/or submit a site map with all required content. <br />A site map does not indicate the location of the Purac Form SO4. A site map shall contain a north orientation. <br />loading areas. internal roads, adjacent streets, storm and sewer drains, access and exit points, emergency shutoffs, <br />evacuation staging areas, hazardous material handling and storage areas. and emergency response equipment. <br />Immediately log into the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov/, upload the <br />correct or updated information, and submit to the EHD for approval. <br />This is a minor violation. <br />Overall Inspection Comments: <br />Conducted a hazardous materials business plan (HMBP) inspection. There were two violations during the <br />inspection. <br />Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br />documenting the corrective actions that have been or will be taken for each violation, and any supporting <br />paperwork, by 07/2112017 . <br />Notes: <br />The Liquid Smoke totes in the Hot Dog Dry Storage Area is labeled with Purac Form SD 4 label. Replace the <br />label to read the correct information. <br />AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br />THIS FACILITY BACK INTO COMPLIANCE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />Received by: Data: June 21. 2017 <br />Inspector: <br />Inspector Phone: <br />Print" Name and Title: <br />HAZA SAEED. REHS <br />(209) 953-6212 <br />=•1 Kevin Smith, Inspection Report for Costco Wholes <br />END 111-01 Rev. OWMI6 <br />FAM10273 PRO512561 SCM( 06I21R017 <br />Page 2 of 2 Hata sous 6lateriala program OR <br />