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Aft <br />Ank <br />San Joaquin County ROW <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />San Joaquin General Hospital <br />Facility Address: <br />500 W Hospital Rd, French Camp <br />Date: <br />August 25, 2016 <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />Item # <br />Remarks <br />209 <br />CCR 2715(c) Designated operator did not inspect all required items and/or the inspection reports not completed. <br />-The designated operator failed to accurately document all alarms on the monthly inspection report. The February <br />2016 designated operator inspection report noted the sump alarm on 1/20/16. According to the alarm printout <br />attached to the facility alarm log, the alarm occurred on 1/18/16 and cleared on 1/20/16. <br />-The designated operator failed to attach a complete alarm history on the designated operator monthly inspection <br />reports. The alarm history attached to every inspection report shows the most recent alarm as 8/17/15 (the date of <br />the last monitoring system certification). Alarm histories brought up on the computer at the time of inspection and an <br />alarm printout attached to the alarm log list a printer alarm in 2/2016 and a sump alarm on 1/18/16. <br />-The date printed on the alarm history printouts attached to the December 2015 and January 2016 designated <br />operator inspection reports did not match the date of inspection on the report. The December report was dated <br />12/18/16 - the attached alarm history was dated 1/25/2000. The January report was dated 1/18/16 - the attached <br />alarm history was dated 2/25/2000. <br />During the monthly inspection, the designated operator shall review the alarm history for the previous month, check <br />that each alarm was documented and responded to appropriately, and attach a copy of the alarm history with <br />documentation taken in response to any alarms to the monthly report. Ensure that designated operators performing <br />monthly inspections at this facility are including all of the required information on the reports. <br />This is a minor violation. <br />Overall Inspection Comments: <br />An inspection checklist was provided to the facility operator at the time of inspection. The EHD has written the <br />complete report which replaces the initial checklist. <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, within 30 days of receiving the complete inspection report. <br />Please be aware that as of January 1, 2014, facility operators are required to upload the following UST program <br />documents into the California Environmental Reporting System (CERS): UST Monitoring Site Plan, UST <br />Certification of Financial Responsibility, UST Response Plan, UST 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 />Documents reviewed: Designated operator (DO) monthly inspection reports, DO training log, CERS submittals, <br />alarm history, invoices/maintenance records, test results, alarm logs <br />Documents provided: Return to Compliance Certification form, Schedule of free CUPA classes <br />Page 5 of 6 <br />