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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.slcehd.com <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> AA Q FacilityQ /+ Inspection <br /> Namey �r L ,�L�i/�f �� U Phone: 2 �9" �6'UB Date: 1,31 <br /> 3 2OZ1 <br /> Facility Q02 A, ISM of �n��C� / /� ID: <br /> CERS <br /> Address: (7 L ` / , ` t/ `/"� ID: <br /> Inspection / /�� Title: Phone: <br /> Contact: ��f L/o / t��7�l �L�� /�Z�/Z O e �'� p6 7 0 9- 007�-20�0 <br /> Inspection Progra <br /> Type: 40a t6/?� 2 / <br /> Con nit Given For:/ Consent <br /> nspection mePhotos ❑ Sampling Given By: f o � (,L <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 I R I 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) ❑ ❑ <br /> 4 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345) V1 ❑ ❑ <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 (v348) Z/ ❑ ❑ <br /> 8 HSC 2551 Failed to submit a training program or program is not reasonable or adequate for facility (V350) :U/ ❑ ❑ <br /> 9 HSC 25508.2 Failed to annually review and certify that the business plan is complete, accurate, and up to date (V342) V ❑ ❑ <br /> 10 HSC 25508.1(a-f) Failed to submit revisions to HMBP within 30 days of substantial change in operations (V346) Cl ❑ ❑ <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) Vol ❑ ❑ <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) ❑ ❑ ❑ <br /> SUMMARY OF VIOLATIONS <br /> CLASS I, CLASS II, or MINOR — Notice to Comply <br /> on te- '4hot;t <br /> c uin,& he sin �ss0 �n�� ol- � 2���loLcsAA <br /> s04 en-ta <br /> ALL EHD STAFF TLM9 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 by (signature): Title: Date: <br /> mq �-74q Ate- �b Z'oV4) — Tbi'XtMeAt- D c -45- 3 /20 zl <br /> Received b (printed name):^ Inspector: Inspector phone: <br /> Azz�d o � ltifj IG � L.o�h -f� � 209 `6O , D62-3 <br /> EHD 19-01 REV 07/28/16 Pagel HM INSPECTION REPORT <br />