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.) 40.41.1f SAN/JOAQUIN <br />-COUNT`, <br />Grenr , <br />Environmental Health Department <br />Hazardous Materials Program Inspection Report <br />Facility Name: <br />Mossdale Chevron <br />Facility Phone: <br />(209) 234-2500 <br />Date: <br />July 25, 2017 <br />Facility Address: <br />444 W MOSSDALE RD, LATH ROP, CA 95330 <br />CERS ID: <br />10180551 <br />Inspection Contact <br />Gagan Dhillon <br />Title: <br />Cashier <br />Phone: <br />(209) 234-2500 <br />Inspection Type: <br />ROUTINE INSPECTION - Operating Permit <br />Program: <br />1920 - HMBP -Common Materials <br />Consent For: <br />El Inspection I=1 Photos El Samples <br />Consent Given By: <br />Gagan Dhillon, Cashier <br />CCR = Title 19 California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations <br />V = Violation R = Repeat violation COS = Corrected on site during inspection <br />Violations <br />1 SJO 4432 Failed to pay annual operating fees DV oR oCOS <br />2 HSC 25505, 25508(a) <br />(1) <br />Failed to complete and electronically submit a hazardous materials business plan oV oR oCOS <br />3 HSC 25507 Failed to establish and implement a hazardous materials business plan oV o R o COS <br />4 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page oV oR o COS <br />5 HSC 25505(a)(1) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site oV oR oCOS <br />6 HSC 25505(a)(2) Failed to complete and/or submit a site map with all required content V oR oCOS <br />7 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release oV oR o COS <br />8 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility oV oR aCOS <br />9 HSC 25508(a)(1) Failed to annually review and certify that the business plan is complete, accurate, and up to date oV oR oCOS <br />10 HSC 25508.1(a)-(f) Failed to submit revisions to business plan within 30 days of substantial change in operations oV oR a COS <br />11 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel oV oR o COS <br />12 HSC 25505(c) Failed to have the business plan readily available to facility or EHD personnel oV oR oCOS <br />13 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program DV oR DCOS <br />15 HSC 25510(a) Failed to report actual or threatened release to the EHD and/or CalOES Warning Center oV oR oCOS <br />16 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements oV oR oCOS <br />17 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements oV oR oCOS <br />18 HSC 25505, 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed iacility exemptions oV oR oCOS <br />19 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report oV oR oCOS <br />1010 See below Unlisted Administration/Documentation violation aV oR oCOS <br />1040 See below Unlisted Release/Leaks/Spills violation DV DR oCOS <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />Item # Remarks <br />FA0000212 PR0520915 SC001 07/25/2017 <br />Page 1 of 2 Hazardous Materials Program OIR <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com <br />EHD 19-01 Rev. 9/20/2019