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4 <br /> 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.secehd.com <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> Facility © I n ` Facility Inspection <br /> Name: % (/I, � rA-4e.� �_-tJ , Phone:�9~ b37-870 b Date: Z <br /> FacilityL l CERS <br /> Address: 2 Z 9 42✓O k � 4 S ( D G �o .� `J b 2 0 3 ID: O vl <br /> Inspection Ti e: Phone: <br /> Contact: ctc� L Q�-c�� �✓ g— —yx <br /> Inspection !�D L Program: <br /> Type t�G vZ 01 / ' 1G r <br /> Consent Given For. Consent( <br /> Anspection 25Photos ❑ Sampling Given By: <br /> CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code 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 plan (V335) ❑ ❑ <br /> 25508 a 1 <br /> 3 HSC 25507 Failed to establish and implement a hazardous materials business plan (V334) X ❑ ❑ <br /> 4 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345) x ❑ ❑ <br /> 5 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site (V343) J< ❑ ❑ <br /> 6 HSC 25505(a)(3) Failed to complete and/or submit a site map with all required content (V347) x ❑ ❑ <br /> 7 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release (V348) ❑ ❑ <br /> 8 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility (V350) ❑ ❑ ❑ <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 HiVIBP 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) X ❑ ❑ <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) ❑ Cl ❑ <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 /> dht tin CA Cx(/ m�' 2 V- K o , alb <br /> ALL EHD TIME AS CIATED WITH FA ING O COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THI ACI IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by gn Dater <br /> Receiv d by (prin ame): Inspector: Inspector phone: <br /> �0 64 � to Z <br /> EHD 19-01 REV 01/28/16v I Page 1 HIM INSPECTION REPORT <br />