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Environmental Health Department <br />Underground Storage Tank Program Inspection Report <br />Date: <br />November 18, 2020 <br /> Facility Address: <br /> 1420 N Tracy Blvd, Tracy <br /> Facility Name: <br /> Sutter Valley Hospitals dba Sutter Tracy <br />Other Violations <br /> 2010 □ V □ R □ COSUnlisted General violation See below <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />RemarksItem # <br /> 107 HSC 25292.2; CCR 2711(a)(11) Failure to submit and maintain complete and current financial responsibility <br />documents. <br />1) OBSERVATION: Financial responsibility documents have not been submitted to the EHD. The insurance <br />documents are dated through 7-1-2020. <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 />------------------------------------------------------------- <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 was corrected on site. <br />This is a repeat violation, Class II. <br /> 109 CCR 2715(a)(1)(B), 2715(a)(3) Failure to submit "Designated Underground Storage Tank Operator Identification <br />Form" within 30 days. <br />OBSERVATION: A new designated operator, Matthew Hughes, began conducting inspections on 4/9/2020 and <br />notification was not provided to the EHD within 30 days of the change. <br />REGULATION GUIDANCE: The owner or operator shall submit a "Designated Underground Storage Tank Operator <br />Identification Form" no later than 30 days after any change in the designated UST operator(s). <br />CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS) at <br />http://cers.calepa.ca.gov and upload the notification identifying all the designated operators for this facility. <br />This is a minor violation. <br />FA0002562 PR0231736 SC001 11/18/2020 <br />EHD 23-01 Rev. 9/16/2020 Underground Storage Tank Program OIRPage 4 of 6 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD