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SAN aIOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sicehd.com HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT V R Facility � ---� 'f. � t.1 Facility Phone: Zo��Qb'S- Inspeciion Date: � Z/ Name: 0.� � D C, L Failed to complete and electronically submit a hazardous materials business plan (V335) � ❑ Facility � l �{", ��--yy Q ��• —if l + � y ��l,tiT0. � 1•C(1�• �� C. CERS ID: �I�L � Address: © 4 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345) � ❑ Inspection �. Contact: r a 11 r -I S ' ® r' ✓✓ Y�. Title: d • c� st,KQ, t.✓ ,S2 I 'Z. Phone: 2.d 1- '�.� d Inspectio�j • � ( � Prog m: Z— ,� ❑ TYPe� f�,0 i� � •t,^a-Tin 8 �Gv' w� . Failed to submit a training program or program is not reasonable or adequate for facility (V350) � ❑ Consent Given For: Cons nt � Failed to annually review and certif`j that the business plan is complete, accurate, and up to date (V342) ❑ ❑ Inspection Photos ❑Sampling Given By: Q,� Q, Failed to submit revisions to HMBP within 30 days of substantial change in operations (V346) ❑ ❑ C R =California Code of Regulations HSC =Health and Safety Code CFR = Co of Federal Regulations SJO =San Joaquin County Ordinance ❑ ❑ V =Violation R =Repeat COS =Corrected on site during inspection EHD 19-01 REV 07/28/16 V rage i r11V1 IIVJr LV I IVIV I ILI vl 1I Violations V R COS 1 SJO 4432 Failed to pay annual operating fees (V851) ❑ ❑ ❑ 2 HSC 25505, 25508 a 1 Failed to complete and electronically submit a hazardous materials business plan (V335) � ❑ ❑ 3 HSC 25507 Failed to establish and implement a hazardous materials business plan (V334) �(, ❑ ❑ 4 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345) � ❑ ❑ 5 6 HSC 25506(a) HSC 25505(a)(3) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site (V343) Failed to complete and/or submit a site map with all required content (V347) �(' � ❑ ❑ ❑ ❑ 7 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release Ivaae> ,� ❑ ❑ 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 certif`j that the business plan is complete, accurate, and up to date (V342) ❑ ❑ ❑ 10 HSC 25508.1 (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) Insp ctor: ❑ ❑ 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 CaIOES Warning Center (V338) ❑ ❑ ❑ 15 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements (351) ❑ ❑ ❑ 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) ❑ ❑ ❑ EHD 19-01 REV 07/28/16 V rage i r11V1 IIVJr LV I IVIV I ILI vl 1I SUMMARY OF VIOLATIONS CLASS II, or MINOR — Noticeff to Com I /1,/CLASS / � o; l a�c� a� �' o.•�, K.t L r C / ✓L •t C'i / c5 [ti ✓ vL. c� ✓ . !� O �''D (� !moi -tom ll�cri'' / d' n • _ �. � ALL EHD AFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. THIS FACILITY S SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. Received by (signatur Title: �,� Date: � zl Received by (printed name): � Insp ctor: Inspector phone: n�nr EHD 19-01 REV 07/28/16 V rage i r11V1 IIVJr LV I IVIV I ILI vl 1I