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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, Califomia 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) .468-3433 Web: www.sicehd.com <br />r_nu is -u i rcw UnZ-oi io 1 rage q HM INSPECTION REPORT <br />HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br />FacilityI <br />Name: <br />y/ <br />7'v <br />Facility <br />Phone: 2LOT— %1.7-r- `y,"11 <br />Inspection <br />Date: (G At q / r <br />Facility �% <br />J <br />ICERS <br />D: A11A <br />Inspection <br />Contact: Cc✓i <br />`Gc s <br />Title: <br />�(JJKQ✓ <br />Phone: <br />Inspection <br />Type: <br />Program: `'? 20 <br />Co sent Given For. <br />Inspection hotos ❑Sampling <br />Consent <br />Given By: %� CG 14 <br />CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Fe eral 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 a 1 <br />Failed to complete and electronically submit a hazardous materials business Ian 335 <br />p N ) ❑ ❑ <br />3 HSC 25507 <br />Failed to establish and implement a hazardous materials business plan (V334) ,I( ❑ ❑ <br />4 HSC 25508(a)(1) <br />Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345) ❑ ❑ <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(a)(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 ivaaai ❑ ❑ <br />8 HSC 25505(a)(4) <br />Failed to submit a training program or program is not reasonable or adequate for facility (V350) ❑ 119 <br />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-0 <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 (1/349) [03❑ <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 handler 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 25507.2 <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 Administration/Documentation violation (V355) ❑ ❑ ❑ <br />1040 See below <br />Unlisted Release/Leaks/Spills violation (V356) ❑ ❑ ❑ <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS 11, or MINOR — Notice to Comply <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 />Re s gnature : <br />Title:Date: <br />oP �14I <br />g1 <br />Received by (pn <br />d^4 <br />Inspector. <br />20 Le�� .e.Z <br />Inspector phone: <br />(2o5 `iS3-6Z/ <br />r_nu is -u i rcw UnZ-oi io 1 rage q HM INSPECTION REPORT <br />