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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.s'cehd.com <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> Facilit Facility p11 Inspection <br /> y Phone: 2 09-4FS —O 7�i C Date: 3IW2I <br /> Name: G , A r � <br /> Facility uQ(7 �1�L (� / /, CERS <br /> Address: / U v fTT Az �J`�(�, I D: <br /> Inspection / nn Title: Phone: <br /> Contact: ���G 0 / l 1L�jJ/ �'6L�Dt —fn4�il� ODe 6QCt0 er 109 —60 7 — Zoo <br /> Inspection Program: <br /> Type: goCG�/11 {i <br /> Cogg ent Given For- Consent /t ��j /�t2 ^ ,ta5�/ <br /> �/fnspection ;Photos ❑ Sampling Given By: A G / V <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 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) 4� ❑ ❑ <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) q/ ❑ ❑ <br /> 5 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site (V343) 2/ ❑ ❑ <br /> 6 HSC 25505(a)(3) Failed to complete and/or submit a site map with all required content (V347) V/ ❑ ❑ <br /> 7 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release (v348) d ❑ ❑ <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 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 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) ° 1 ° ° <br /> SUMMARY OF VIOLATIONS <br /> CLASS I, CLASS II, or MINOR — Notice to Comply <br /> g� o i rn v�r� S >� he�v� �� f5 �aGt pJ2 S!Z`e T ke ka.4 i2 e <br /> ^S� at 6e <br /> 1M ►2 -blte L A //-,6,n nVt sonm'.0izti ,�� �6 ) ;� SevZelyt C�lzS <br /> A b'0 x i In o, 1°I /5o a`lan s 0� ,y itx`� f/ 0�/z l06¢ � ��;�e <br /> ourtid on s r _ <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 ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by (signature): Title: Date: <br /> N'0 ti, rt fit% 6-0 Cavid II 9 UeAtfmmlri� © A S 2 0Z <br /> Receive Ay (printed name): Inspector: Inspector phone: <br /> EHD 19-01 REV 07/28/16 Page 1 HM INSPECTION REPORT <br />