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Page 1 of 6 San Joaquin County 11W Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd PEND D / Underground Storage Tank Program Inspection Report Facility Name: San Joaquin General Hospital Facility Phone: (209) 468-6812 Date: August 25, 2016 Facility Address: 500 W Hospital Rd, French Camp, CA 95231 CERS ID: 10643278 Inspection Contact: Jesse Escotto Title: Engineer Phone: () - Inspection Type: ROUTINE INSPECTION - Operating Permit Program: 2361 - UST FACILITY Consent For: 0 Inspection Z Photos 0 Samples I Consent Given By: I Vincent Cabales, Leadman Service Technician Onsite: Exp. Date: Jesse Berumen/Zane Nimmo 06/09/2018 Designated Operator: Jesse Berumen Exp. Date: 05/24/2018 Service Technician Manufacturer's Training OPW (JB), 11/23/17; Tank Tester(ZT), 03/31/19; Service Tech (ZT), 06/19/17 CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations V = Violation R = Repeat violation COS = Corrected on site during inspectio File ,Review" 101 HSC 25284 No permit to operate ❑ V ❑ R ❑ COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system ❑ V ❑ R ❑ COS 103 HSC 25292.2 Current financial responsibility documents not submitted ❑ V ❑ R ❑ COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ❑ V ❑ R ❑ COS 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan ■ V ❑ R ❑ COS 106 CCR 2632(d)(2) Failed to have an approved UST response plan ❑ V ❑ R ❑ COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ■ V ❑ R ❑ COS 108 CCR 2637(f), 2638(e) Failed to notify the EHD 48 hours prior to conducting testing ❑ V ❑ R ❑ COS 109 CCR 2637 Failed to test secondary containment ❑ V ❑ R ❑ COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑ V ❑ R ❑ COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually ❑ V ❑ R ❑ COS 112 HSC 25284.2 Failed to test spill containers annually ❑ V ❑ R ❑ COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days ❑ V ❑ R ❑ COS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down ❑ V ❑ R ❑ COS 115 CCR 2715(a) Failed to inform the EHD of designated operator identification or change within 30 days ❑ V ❑ R ❑ COS 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V ❑ R ❑ COS 117 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ❑ V ❑ R ❑ COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑ V ❑ R ❑ COS 119 HSC 25299 Documents were falsified or misrepresented ❑ V ❑ R ❑ COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑ V ❑ R ❑ COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑ V ❑ R ❑ COS 122 CCR 26310) Failure to submit UST system component statement of compatibility for substance stored ❑ V ❑ R ❑ COS On Site Records 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions ■ V ❑ R ❑ COS 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 1/2 years ❑ V ❑ R ❑ COS 203 CCR 2712(b) Failed to maintain records of monitoring, repair, lining, and upgrades on site ❑ V ❑ R ❑ COS Page 1 of 6