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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 /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> Facility Facility �� �j Inspection <br /> Name: LA, Phone: �204 9t / � 2SDate: 2c7 / 7 <br /> Facili ++ 11 11 � <br /> Address: 3131 �Jt 65' Q -' it S +miz: k D: _ /� <br /> Inspection Title: hone:: <br /> Contact: <br /> inspectio Program: <br /> Type a i n IC a+ ci Z r 42 ' Vek- i we a P I �t 2. 0 <br /> Consent Given For. Cons nt <br /> ❑ Inspection ❑ Photos ❑ Sampling Given By: (j cxm �" CD O <br /> CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federa Rbgulations 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 a505, Failed to complete and electronically submit a hazardous materials business plan (V335) El 11 <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) r ❑ ❑ <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 NuB) ❑ ❑ <br /> 8 HSC 25505(a)(4) Failed to submit a training program or program Is not reasonable or adequate for facility (V350) f ❑ ❑ <br /> 9 HSC 25508.2 Failed to annually review and certify that the business plan is complete, accurate, and up to date (V342) ❑ ❑ <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) ❑ ❑ <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 CaIOES Warning Center (V338) ❑ ❑ ❑ <br /> 15 HSC 25507. 1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements (351 ) in ❑ ❑ <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) ❑ ❑ ❑ <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I , CLASS II , or MINOR — Notice to Comply <br /> � l f c.LL14 S o t- s a LOS RZ <br /> -e� <br /> �F <br /> s2 U �z o 4E (25 L/% <br /> ✓'t7 v � !L i <br /> 1= VA 1 � � Jess abfi ,ro 4e 2L arsC?M <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 ANYTIME AT EHD' S CURRENT HOURLY RATE. <br /> Received by (si atu Title: Date: / <br /> ovNcr (" 2< L l �? <br /> Received by (printed name): �j Inspector. Inspector phone: <br /> nt <br /> EHD 19-01 REV 07/28/16 Page 1 HM INSPECTION REPORT <br />