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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.s*cehd.com <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> Facility FacilityInspection <br /> Name: fe5 Phone:?O J�- Date: ;2_16/2:�� <br /> Facility <br /> Address: CEF- <br /> ID: _ <br /> InspectionQ itle: ,�f <br /> Contact: � AA C 5 .n k �l7(! ��(i Phone: Z79_G7 9& <br /> Inspection I <br /> / Program- <br /> Type: <br /> urn 2� gLOar�(�ous /1/1e26>A�,�u9irr�c /blan <br /> Co sent Given For: Consent / <br /> Inspection > otos ❑ Sampling I Given By: off--a 471C <br /> CCR=California Code of Regulations HSC=Health and Safe Code CFR=CoAde 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 Failed to pay annual operating fees(V851) ❑ ❑ ❑ <br /> 2 HSC 25505, Failed to complete and electronically submit a hazardous materials business Ian V335 <br /> 25508 a 1 p ( ) ❑ <br /> 3 HSC 25507 Failed to establish and implement a hazardous materials business plan(V334) ❑ <br /> 4 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page(V345) ❑ ❑ <br /> 5 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site(V343) ❑ ❑ <br /> 6 HSC 25505(a)(3) Failed to complete and/or submit a site map with all required content(V347) ❑ ❑ <br /> 7 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release(vw) ❑ ❑ <br /> 8 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility(V350) 4/ 11 ❑ <br /> 9 HSC 25508.2 Failed to annually review and certify that the business plan is complete,accurate,and up to date(V342) p/ ❑ ❑ <br /> 10 HSC 25508.1(a-f) Failed to submit revisions to HMBP within 30 days of substantial change in operations(V346) ❑ ❑ ❑ <br /> 11 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel(V349) a/ ❑ ❑ <br /> 12 HSC 25505(c) Failed to have the business plan readily available to facility or EHD personnel(V850) ❑ ❑ <br /> 13 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program (V341) ❑ ❑ ❑ <br /> 14 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center(V338) ❑ ❑ ❑ <br /> 15 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements(351) ❑ ❑ ❑ <br /> 16 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements(V352) ❑ ❑ ❑ <br /> 17 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions(V353) ❑ ❑ ❑ <br /> 18 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report(V808) ❑ ❑ ❑ <br /> 1010 See below Unlisted Administration/Documentation violation(V355) ❑ ❑ ❑ <br /> 1040 See below Unlisted Release/Leaks/Spills violation(V356) :1 ❑ <br /> SUMMARY OF VIOLATIONS <br /> CLASS I CLASS 11,or MINOR—Notice to Comply <br /> I n Ve <br /> e eA�a I Re- 62'1' 5-t / . <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 /> Received b nature): Title: Date: <br /> 2 '11 � / Z - "" If <br /> Re ved 6y(printed name): Inspector: Inspector phone: <br /> I/;� ' L � �1��'� 2,07-W-062- 3 <br /> EHD 19-01 REV 07/28/16 Pagel HM INSPECTION REPORT <br />