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Nov. 14. 2018 4:3OPM cff IV <br /> 0 ED <br /> 15 <br /> San Joaquin County IV 2018 <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue,Stockton,California 96205-6232 EN\JIR0t4MF-t4TAL <br /> Telephone. (209)468-3420 Fax:(209)468-3433 Web.www.slov.ora/ehd9-) `t <br /> Facility <br /> Facility Name: Facility Address'. <br /> LOBI MEMORIAL HOSPITAL 976 S FAIRMONT AVE LODI October 16,2018 <br /> I W-07 <br /> item# <br /> Remarks <br /> 70-7 CCRR 2632(d)(1) Plot plan/site map not submitted or failed to completely show where monitoring Is performed. <br /> An accul-15 U Monitoring Site Plan was not submitted. The map does not include piping. A site plan must be <br /> I <br /> U <br /> ed tifying the locations where monitoring will be performed. Immediately log into the California <br /> E r <br /> nvir ental Reporting System(CERS)at http,//cers.calepa.ce.gov/and upload a copy of the UST Monitoring Site <br /> an. <br /> This is a repeat violation,Class If. <br /> � <br /> 637(f]i Failed to submit"Secondary Containment Testing Report Form"within 30 days after the test, <br /> Pecondary containment <br /> ntainment testing was performed on 10124/17 and a test report was submitt-R-on 120117,one month <br /> late. AVopy of the test report must be submitted within 30 days of the tests. Take all necessary precautions to <br /> e testing and submittal of test reports are performed in a timely manner. <br /> This is a minor violation. <br /> 202 CCR 2716(c)(3),2716(c)(4)Failure to maintain the"Facility Employee Training Certificate!' n-site(after October 1, <br /> 2018). <br /> Designated operator training for two employees Was conducted in October 2018 and the new form was not used. All <br /> training documentation should be done on the Facility Employee Training Certificate as of October 1,2018. <br /> Immediately update the training to be documented on the correct form. <br /> This is a minor violation. 0 4/0&" <br /> 206 CCR 2712 Failure to comply with UST operating permit conditions. <br /> Work orders indicate that the 84 sensor was found to need replacement on 8/17/18 and was replaced on 110/2/18. <br /> The required documentation was not found on site for the technician or the testing. Immediately obtain a permit for <br /> this repair from the EHI). A failure to obtain a permit penalty may apply. <br /> This is a repeat violation,Class 11. r /'zq let4l <br /> 209 CCR 2716(ae)Failure to conduct the designated UST operator visual inspection at least once every 30 days. <br /> The designated operator inspection report was conducted on September 13,2018 and again in October 2018, The <br /> October report was not documented on the now form. Immediately begin conducting all designated operator <br /> inspections using the required forms. <br /> This is a minor violation. I/ r� <br /> I <br /> FAOM513 PR=1331 SC001 10MMI8 <br /> EHO 23.01 Rev,09/22A6 Page 5 of 6 uaderarwrA stm9e Tank Program OR <br />