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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.sl-qov.org/ehd <br />g <br />';U S <br />u!d_tor­T­n- kProgram W"n"U" Rep p r <br />'Anddgb'd <br />Facility Name: <br />Facility Address: Date: <br />San Joaquin General Hospital <br />500 W Hospital Rd, French Camp August 21, 2017 <br />v. <br />us1S' <br />323 <br />HSC 25283.5(a) <br />Unburied below grade UST system failed to meet exemption status <br />❑ V o R o COS <br />324 <br />CCR 2717.1(g) <br />Tampered with red tag <br />Ej V o R c COS <br />325 <br />CCR 2717.1(f) <br />Deposited petroleum into a red tagged UST <br />o V o R o COS <br />326 <br />HSC 25299(a)(9) <br />Tampered with or disabled leak detection devices or alarms <br />Ei V o R o COS <br />327 <br />CCR 2631.1 <br />UST system not compatible with the substance stored <br />ii V o R o COS <br />328 <br />HSC 25298 <br />Failed to comply with temporary closure requirements <br />o V c R o COS <br />329 <br />HSC 25298 <br />Failed to comply with permanent closure requirements <br />ii V c R o COS <br />330 <br />CCR 2636(f)(6) <br />Failure to meet all requirements in lieu of a line leak detector for emergency generator tank system <br />c V c R o COS <br />g reWr zed, <br />A� 1 ��kpifig' <br />401 <br />CCR 2636(a)(3) Suction piping not properly sloped or incorrectly located check valve <br />c V o R c COS <br />402 <br />CCR 2643(d) Daily monitoring of suction pipe (pre -Jan 1984) not performed <br />o V ii R c COS <br />403 <br />CCR 2643(d) Triennial 0.1 gph line test for conventional suction piping not performed (pre -January 1984) <br />o V o R u COS <br />404 <br />CCR 2643(e) Biennial 0.1 gph test for gravity piping not performed (pre -January 1984) <br />11 V [I R o COS <br />k* QttIelr Vinfafioris <br />'* <br />2010 <br />See below <br />Unlisted Administration/Documentation violation <br />❑ V o R o COS <br />2030 <br />See below <br />Unlisted Operations/Maintenance violation <br />❑ V u R Ei COS <br />2060 <br />See below <br />Unlisted Design/Construction violation <br />o V o R j COS <br />T, 4s' <br />SUMMARYh IL: "Of <br />X <br />(CIA, SS li, CLA9&I1�jorM 10cty) <br />Item # <br />Remarks <br />206 <br />CCR 2712 Failure to comply with UST operating permit conditions. <br />A copy of the UST operating permit was not found on site. A copy of the UST operating permit and all attachments <br />and conditions shall be retained at the facility. Immediately obtain a copy of the permit and retain it on site. <br />This is a repeat violation, Class 11. <br />Overall Inspection Comments: <br />Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br />documenting the corrective actions that have been or will be taken for each violation, and any supporting <br />paperwork, by 9/20/2017. <br />Please be aware that as of January 1, 2014, facility operators are required to upload the following LIST program <br />documents into the California Environmental Reporting System (CERS): LIST Monitoring Site Plan, LIST <br />Certification of Financial Responsibility, LIST Response Plan, LIST Letter from Chief Financial Officer (if <br />applicable), and the Owner Statement of Designated Operator Compliance. The UST Owner/Operator: Written <br />Agreement, if applicable, can be stored at the facility or uploaded into CERS. <br />Note: The Annual Line Test was conducted today, 8/21/2017, by service technician Felix Ramirez (Petro Tight <br />- <br />8/26/2017) <br />FA0000086 PR0231614 SCO01 08/21/2017 <br />EHD 23-01 Rev. 09122/16 Page 3 of 4 Underground Storage Tank Program OIR <br />