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San Joaquin County <br />Environmental Health Department ENDS <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 ��.£__LL_" 1 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd <br />W <br />�an port <br />Encerground.Storage Tank ProgartfintRe .. <br />Facility Name: <br />San Joaquin General Hospital <br />Facility Phone: <br />(209) 468-6812 <br />Date: <br />August 21, 2017 <br />Facility Address: <br />500 W Hospital Rd, French Camp, CA 95231 <br />CERS ID: <br />10643278 <br />Inspection Contact: <br />Jesse Berumen <br />Title: <br />Designated Operator <br />Phone: <br />(209) 367-4800 <br />Inspection Type: <br />ROUTINE INSPECTION - Operating Permit <br />Program: <br />2361 - UST FACILITY <br />Consent For: <br />0 Inspection 0 Photos 0 Sample <br />Consent Given By: <br />Jesse Berumen, Designated Operator <br />Service Technician Onsite: Exp. Date: <br />Jesse Berumen/Felix Ramir 06/09/2018 <br />Designated Operator: Exp. Date: <br />Jesse Berumen 05/24/2018 <br />Service Technician Manufacturer's Training: <br />OPW (JB), 11/23/17; Tank Tester (FR), 05/31/20; Service Tech (FR), 11/22/18 <br />CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations <br />V = Violation R = Repeat violation COS = Corrected on site during inspection <br />Fite Rev OW <br />101 <br />HSC 25284 <br />No permit to operate <br />❑ V ❑ R ❑ COS <br />102 <br />HSC 25284(a)(3) <br />No written agreement between tank owner and tank operator to monitor the tank system <br />❑ V o R ❑ COS <br />103 <br />HSC 25292.2 <br />Current financial responsibility documents not submitted <br />❑ V ❑ R ❑ COS <br />104 <br />CCR 2711 <br />UST operating permit application for facility and tank information not submitted or current <br />❑ V ❑ R ❑ COS <br />105 <br />CCR 2632(d)(1) <br />Failed to have an approved UST monitoring plan <br />❑ V ❑ R ❑ COS <br />106 <br />CCR 2632(d)(2) <br />Failed to have an approved UST response plan <br />❑ V ❑ R ❑ COS <br />107 <br />CCR 2632(d)(1)(C) <br />Plot plan/site map not submitted or failed to completely show where monitoring is performed <br />❑ V ❑ R ❑ COS <br />108 <br />CCR 2637(f), 2638(e) <br />Failed to notify the EHD 48 hours prior to conducting testing <br />■ V ❑ R ❑ COS <br />109 <br />CCR 2637 <br />Failed to test secondary containment <br />❑ V n R ❑ COS <br />110 <br />CCR 2637(e) <br />Failed to submit secondary containment test report within 30 days <br />❑ V ❑ R ❑ COS <br />111 <br />CCR 2638(a) <br />Failed to test monitoring and leak detection equipment annually <br />❑ V ❑ R n COS <br />112 <br />HSC 25284.2 <br />Failed to test spill containers annually <br />❑ V ❑ R ❑ COS <br />113 <br />CCR 2638(d) <br />Failed to submit monitoring system certification test report within 30 days <br />❑ V ❑ R ❑ COS <br />114 <br />CCR 2636(f) <br />Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down <br />❑ V ❑ R a COS <br />115 <br />CCR 2715(a) <br />Failed to inform the EHD of designated operator identification or change within 30 days <br />❑ V ❑ R ❑ COS <br />116 <br />CCR 2715 <br />Designated operator, service tech or installer did not possess current ICC certification <br />❑ V ❑ R ❑ COS <br />117 <br />CCR 2663 <br />Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after <br />❑ V ❑ R ❑ COS <br />118 <br />CCR 2663 <br />Failed to submit tank lining certification within 30 days or to conduct proper tests <br />❑ V o R ❑ COS <br />119 <br />HSC 25299 <br />Documents were falsified or misrepresented <br />❑ V ❑ R ❑ COS <br />120 <br />CCR 2635(d) <br />Failed to submit UST Certification of Installation/Modification <br />❑ V ❑ R ❑ COS <br />121 <br />CCR 2712(f) <br />Failed to submit a written response within 30 days of receiving an inspection report <br />c V ❑ R ❑ COS <br />122 <br />CCR 26310) <br />Failure to submit UST system component statement of compatibility for substance stored <br />❑ V ❑ R ❑ COS <br />201 <br />CCR 2712(b) <br />Failed to maintain alarm logs and/or records of follow up actions <br />■ V ■ R ❑ COS <br />202 <br />CCR 2712(b) <br />Failed to maintain cathodic protection test records on site for at least 6 1/2 years <br />❑ V o R ❑ COS <br />203 <br />CCR 2712(b) <br />Failed to maintain records of monitoring, repair, lining, and upgrades on site <br />❑ V ❑ R ❑ COS <br />EHD 23-01 Rev. 09/22/16 <br />FA0000086 PR0231614 SCo01 08/21/2017 <br />Page 1 of 5 Underground Storage Tank Program OIR <br />9171 9690 0935 0152 1404 39 <br />