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AJA d �SS SAN JOAGQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue , Stockton , California 95205 -6232 ( elephone: (209) 468-3420 Fax: (209 ) 468 -3433 Web: www . sicehd . com i ff v - ZARDOUS MATERIALS PROGRAM INSPECTION REPORT Facility ( !f L � � c , Facility Inspection Name: J Phone : Date : g Facility 1 ` 1 / ey CERS Address: VVb Aek A 3 �� r S Z� (p ID : Inspection L Title: Z (� Phone : Contact: -�_ v� �` 0. e ✓ �� a ✓ O T` (Me Y `.,� Z QY . L3 3 Inspectio �! Program : Type : W { V -2.t/'C+- IV "all 2YWL c f 7 LCj Consent Given For: Consent Inspection XPhotos ❑ Sampling Given By: Go . � CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations Sib = San Joaquin County Ordinance V = Violation R = Repeat COS = Corrected on site during inspection Violations V R COS 1 SJO 4432 Failed to pay annual operating fees (V851 ) ❑ ❑ ❑ 2 HSC 255051 25508 (a) ( 1 ) Failed to complete and electronically submit a hazardous materials business plan (V335) K ❑ ❑ 3 HSC 25507 Failed to establish and implement a hazardous materials business plan (V334) x ❑ ❑ 4 HSC 25508 (a) ( 1 ) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345) x ❑ ❑ 5 HSC 25506 (a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site (V343) )t ❑ ❑ 6 HSC 25505 (a) (3) Failed to complete and/or submit a site map with all required content (V347) X ❑ ❑ 7 HSC 25505 (a) (3) Failed to establish and/or submit emergency response procedures for a release or threatened release (v34e) X ❑ ❑ 8 HSC 25505 (a) (4) Failed to submit a training program or program is not reasonable or adequate for facility (V350) ❑ ❑ 9 HSC 25508 . 2 Failed to annually review and certify that the business plan is complete , accurate , and up to date (V342) 11El 10 HSC 25508A (a-f) Failed to submit revisions to HMBP within 30 days of substantial change in operations (V346) ❑ ❑ ❑ 11 HSC 25505 (a) (4) Failed to provide or document initial and/or refresher training to appropriate personnel (V349) '� ❑ ❑ 12 HSC 25505 (c) Failed to have the business plan readily available to facility or EHD personnel (V850) Cl ❑ 13 HSC 25505 . 1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program (V341 ) ❑ ❑ ❑ 14 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center (V338) ❑ ❑ ❑ 15 HSC 25507 . 1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements (351 ) ❑ Cl ❑ 16 HSC 25507. 1 Failed to submit training program when not meeting Ag handler exemption requirements (V352) ❑ ❑ ❑ 17 HSC 25507 .2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions (V353) ❑ ❑ ❑ 18 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report (V808) ❑ ❑ ❑ 1010 See below Unlisted Administration/Documentation violation (V355) ❑ ❑ ❑ 1040 See below Unlisted Release/Leaks/Spills violation (V356) ❑ ❑ ❑ SUMMARY OF VIOLATIONS CLASS I , CLASS II, or MINOR — Notice to Comply 1 S a. IW <tFLaI L a C ul tt,4 .94 w 4s 1/1,01 ME lc::Lv ; l ' ,ec� i ns � e{c ) w � Cir e PVIcz-i ALL EVD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY 7HE ABOVE NOTED DATES WILL Bg BILLED AT THE CURRENT H RLY RATE, THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT END ' S CURRENT HOURLY RATE . Received by signature) : T' Date: p 7L c;L o7 l0 Received by 4kinted nam ): Inspector: Inspector phone: GC1jAo1L0 6 (3 (& ?) q,:5J � & EHD 19-01 REV 7/28/16 Pagel HM INSPECTION REPORT