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SAN 's] DAQ II II Environmental Health Department <br /> C0L.IJT`o' <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Sutter Valley Hospitals dba Sutter Tracy 1420 N Tracy Blvd, Tracy November 06, 2019 <br /> Other Violations <br /> 2010 See below Unlisted General violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 103 HSC 25292.2,25299.30 Failure to submit and maintain complete and current financial responsibility documents. <br /> 1)OBSERVATION: Financial responsibility documents have not been submitted to the EHD. The most recent <br /> financial responsibility documents in CERS are dated 11-7-2018. <br /> REGULATION GUIDANCE: Current financial responsibility documents are required to be submitted annually. <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov/, and upload the required documents. <br /> 2)OBSERVATION: Current financial responsibility documents were not found on site. <br /> REGULATION GUIDANCE:A copy of current financial responsibility documents are required to be maintained on <br /> site. <br /> CORRECTIVE ACTION: Immediately obtain a copy of the facility's financial responsibility documents and maintain a <br /> copy on site. <br /> This is a minor violation. <br /> 118 CCR 2715(a)(1)(A), 2715(a)(2) Failure to submit the"Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> OBSERVATION: The Underground Storage Tank Statement of Understanding and Compliance Form was not found <br /> in CERS. <br /> REGULATION GUIDANCE: This form must be uploaded to the California Environmental Reporting System (CERS). <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov and upload the Underground Storage Tank Statement of Understanding and Compliance <br /> Form for this facility. <br /> This is a minor violation. <br /> FA0002562 PR0231736 SCO01 11/06/2019 <br /> EHD 23-01 Rev.9/20/2019 Page 4 of 6 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />