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pA0000086 pnuu 1m4ucou 08/e/2018 Exouo-01 Rev. 09/22/16 Page 1pys Underground Storage Tank Program om San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.saqov.o[gjgtLd Lk f'k low Facility Name: San Joaquin General Hospital Facility Phone: (209) 468-6812 Date: August 21, 2018 Facility Address: 500 W Hospital Rd, French Camp, CA 95231 CERS ID: .10643278 Inspection Contact: Nicholas Graham -Lewin Title: Authorized representative Phone: Inspection Type: ROUTINE INSPECTION - Operating Permit Program: 2361 - UST FACILITY Consent For: El Inspection N Photos Z Samples Consent Given By: I Alfredo Garcia, Central P1 Int En 'neer Service Technician Onsitec Exp. Date: Zane Nimmo/ Eric Molgaard 06/02/2019 Designated Operator: Nicholas Graham -Lewin Exp. Date: 04/20/2020 Service Technician Manufacturer's Training 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 inspection 7777 101 HSC 25284 Failure to obtain a valid permit to operate from the EHD including but not limited to unpaid fees oV o R ii COS 102 HSC 25284(a)(3)(A)/ No written agreement between tank owner and tank operator to monitor the tank system oV oR Ei COS 103 HSC 25292.2, 25299.30 Current financial responsibility documents not submitted o V D R Ei COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current o V o R ii COS 105 CCR 2632(d)(1), Failed to have an approved UST monitoring plan Ei V o R oCOS 106 CCR 2632(d)(2), Failed to have an approved UST response plan o V oR c COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ii V Li R c COS 108 CCR 2637(f), 2638(e) Failed to notify the EHD 48 hours prior to conducting testing o V c R oCOS 109 CCR 2637 Failed to test secondary containment Ei V oR oCOS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days Ei V oR oCOS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually Ei V oR Li COS 112 HSC 25284.2 Failed to test spill containers annually o V o R o COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days Lj V Li R oCOS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down oV ii R Ei COS 115 CCR 2715(a) Failed to submit to EHD notification of designated operator identification or change w/in 30 days nV oR EiCOS 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification Ei V o R o COS 117 CCR 2663(h) Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after c V Ei R o COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests o V o R oCOS 119 HSC 25299(a)(8), Documents were falsified or misrepresented o V o R Li COS 120 CCR 2635(d) Failed to submit UST Certification of I nsta Ratio n/M od ifi cation o V Ei R ii COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ii V ii R Ei COS 122 CCR 2631 (1) Failure to submit and maintain UST system component statement of compatibility for substance stored o V o R oCOS Wt -T 2 01 CCR 2712(b) Failure to maintain monitoring, maintenance, and follow up action records mV m R o COS pA0000086 pnuu 1m4ucou 08/e/2018 Exouo-01 Rev. 09/22/16 Page 1pys Underground Storage Tank Program om