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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.sicehd.com <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> Facility p/ D // Facility / Q Inspection <br /> Name: VV n��et t� W GL � � Phone:2�9_ C�j�0q6j Date: � ZOZ <br /> Facility /� J) /� CERS <br /> Address: o Y!� a lAve / V PI K -6Llx �l ID: <br /> Inspection �� - Title: Phone: , <br /> Contact: /- /l o /�us5l 7'eeoctynewZ1. 6A o� 2.d7 -(�D�- 2O YC) <br /> Inspection Program: <br /> Type: Aw -l"a-zi 1, PZ 1 <br /> 7ent Given For- Consent <br /> spection ;Photos ❑ Sampling I Given By: A ed/ o ll5lJJ <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) EV ❑ ❑ <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) ❑ ❑ <br /> 5 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site (V343) V/ ❑ ❑ <br /> 6 HSC 25505(a)(3) Failed to complete and/or submit a site map with all required content (V347) q/ ❑ ❑ <br /> 7 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release (vase) q ❑ ❑ <br /> 8 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility (V350) 4/ ❑ ❑ <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) ❑ ❑ ❑ <br /> SUMMARY OF VIOLATIONS <br /> CLASS I, CLASS II, or MINOR — Notice to Comply <br /> Z-5 axnzi o itc <br /> tic i/ e " q biniz�- a �Z� �csMAterf""t� <br /> /Le dal, lfV d/ {o6nl`X �OA meAt�� <br /> 6- r/� S t ram- CE6'S ��X r n� oLte C ov <br /> 1040 u/41 <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 /> No si n iu� tip e7 o ��ed 13'n�t t�1,e� � Op�6�to�' S 6 2, o � l <br /> Received by (printed name): Inspector: Inspector phone: <br /> A tl"t! i a Multi; /V'I'6 1C Lje-A rep q4('018 --C)62 3 <br /> EHD 19-01 REV 07/28/16 Page 1 HM INSPECTION REPORT <br />