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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.sigov.org/ehd <br /> ABOVEGROUND PETROLEUM STORAGE ACT (APSA) PROGRAM INSPECTION REPORT <br /> Facility Facility Inspection <br /> Name: Dameron Hospital Address: 525 W. Acacia, Stockton Date: Feb 7, 2014 <br /> Facility: Jacob Wiebe Title: Lead Engineer Phone: 461-3156 <br /> Inspection <br /> Type: XRoutine ElFollow up ❑Complaint-ID#: ❑Other: <br /> (Authority HSC 252pecti) Jacob Wiebe Mech Lead Engineer <br /> Consent for: p(Inspection 71 Sampling �(Ph01os Granted by: Title: 9 <br /> AST RED DSL DSL DSL DSL Total Facility Shell 10450 <br /> Content Capacity(gal): <br /> Shell ---- ---------- ------- -. __------- ---------- SPCC Plan 5-year <br /> Capacity 10000 150 150 150 Review Date: <br /> SPCC Plan type: ❑APSA SPCC conditionally exempt(HSC 25270.4.5(b)) $Fully or partially Professional Engineer certified ❑Self certified <br /> VIOLATIONS <br /> # C1 C2 M Code Section HSC=California Health and Safety Code;CFR=Code of Federal Regulations <br /> Cl =Class 1 violation;C2=Class 2 violation,M=Minor violation <br /> Aboveground Petroleum StOMININWIF <br /> 101 HSC 25270.4.5(a) Failed to prepare a written SPCC Plan in accordance with CFR Part 112 <br /> 102 HSC 25270.4.5(a) Failed to conduct periodic inspections of the storage tank to assure compliance with CFR Part 112 <br /> 103 HSC 25270.6(a) Failed to file business plan or annual tank facility statement if capacity>1 OK gallons and 25% <br /> petroleum <br /> 104 HSC 25270.6(b) Failed to submit APSA fees <br /> 105 HSC 25270.8 Failed to report spills or releases of 42 gallons or more <br /> - Requiierilehtto Prepare and Impl6'' rit 3'SPCC`PI'Aisr'.""""` <br /> 201 ICFR 112.3(d) SPCCPlan cenification by a Professional Engineer(PE)missing or incomplete <br /> 202 CFR 112.3(e) Failed to retain a copy of the SPCC Plan on site <br /> Amendment of SPCC Plan by owners or operators <br /> 301 CFR 112.5(a) Failed to amend SPCC Plan within 6 months,or implement changes within 6 months of amendment <br /> when there is an applicable change to the facility <br /> 302 CFR 112.5(b) Failed to amend SPCC Plan within 6 months,or implement changes within 6 months of amendment <br /> after scheduled 5 year Plan review <br /> 303 CFR 112.5(b) Failed to complete a review and evaluation of SPCC plan at least once every 5 years <br /> 304 CFR 112.5(c) Failed to have a PE certify technical amendments within 6 months of than e <br /> Qualified Facilities Plan Requjrements <br /> 401 CFR 112.6(a) Tier I qualified facility failed to self-certify(1)SPCC Plan; (2)technical amendment when there was an <br /> applicable change to the SPCC Plan <br /> 402 CFR 112.6(a)(3) Tier I qualified facility SPCC Plan incomplete <br /> 403 CFR 112.6(b) Tier 11 qualified facility failed to self-certify(1)SPCC Plan;(2)technical amendment when there was an <br /> applicable change to the SPCC Plan <br /> 404 CFR 112.6(b)(4) Failed to provide written PE certification in a self-certified plan for alternate methods which provide <br /> environmental a uivalence, or provisions in lieu of seconds containment due to impracticality <br /> :'General Requirements for SPCC Plans <br /> 501 CFR 112.7 Failed to include a cross-referencing section for a Plan that does not follow the sequence specified in this <br /> section <br /> 502 CFR 112.7 SPCC Plan lacks full approval of management at a level of authority to commit the necessary resource <br /> to implement the Plan <br /> 503 CFR 112.7(a)(2) Failed to provide equivalent environmental protection and/or state the reasons for nonconformance and <br /> describe the alternate methods and how they achieve equivalent environmental protection <br /> 504 CFR 112.7(a)(3) No facility diagram or diagram failed to show location and contents of each container,transfer stations, <br /> and connecting i es. <br /> 505 CFR 112.7(a)(3)(i) SPCC Plan failed to include description of product type and storage capacity for each container <br /> 506 CFR 112.7(a)(3)(ii) SPCC Plan failed to include procedures for routine handling of products and discharge prevention <br /> measures <br /> 507 CFR 112.7(a)(3)(iii) SPCC Plan failed to show discharge or drainage controls(secondary containment),equipment,and <br /> rocedures for the control of a discharge <br /> 508 CFR 112.7(a)(3)(iv) ISPCC Plan failed to show countermeasures fordiscovery, response and cleanup of discharges <br /> Inspeclor R ived By Title: <br /> Jeffrey Wong (209) 468-0335 '.)_k 60 <br /> EHD 28-02 Rev 08/19/12 Page 1 APSA INSPECTION REPORT <br />