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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 /> f Facility / Q /+ Inspection 2 <br /> NameyAA <br /> �� L ,�L/i/�� 2-8 Phone: 209" �[�"Utz Date: J�1/ ZO21 <br /> Facility Q /1� � Ia , 0f n ,� �n��C� / /� ID: <br /> CERS <br /> Address: (7 V L / , ` x/ ll/ `/"� ID: <br /> Inspection / /� Title: Phone: <br /> Contact: ��/ L/o / v 1��7�1 �L�� /�l�/Z� O e �'� p6 7 o? 007�-20 <br /> Inspection Pr-. <br /> Type: ��iQ tl/Zif, Z / <br /> Con nit Given For:/ Consent <br /> nspection *`Photos ❑ Sampling Given By: t'�, d Q 61 / <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 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) rZ/ ❑ ❑ <br /> 8 HSC 25505(a)(4) 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) ❑ ❑ <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) vi ❑ ❑ <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 /> 012 /tom eh l t <br /> S/neS <br /> c17 6► ll �r >� s C t /00 <br /> Wkyt <br /> AlL EHD STAFF T 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 /> �vo � i2 i d u{- �b Z'0V4) - Tbi'�,l"MeAt- D 5'%3 <br /> Received b (printed name): Inspector: Inspector phone: <br /> A, ��il�o M. ws, ' IIf )C Lo�h �� �' 2a9 — 7L-:20al�O �3 <br /> EHD 19-01 REV 07/28/16 Page 1 HM INSPECTION REPORT <br />