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SAN J O A R N Environmental Health Department <br /> i , �V <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 /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 209 CCR 2716(a-e) Failure to conduct the designated UST operator visual inspection at least once every 30 days. <br /> 1)OBSERVATION: Designated operator reports were not signed within the required time frame. <br /> REGULATORY GUIDANCE:Within 48 hours of the completion of the designated UST operator visual inspection, <br /> the designated operator shall sign and provide the owner or operator with a copy of the inspection report. Within 48 <br /> hours of being provided a signed copy of the report,the owner or operator shall provide a description of each <br /> corrective action taken or to be taken and shall sign and date the report, acknowledging the identified compliance <br /> issues. <br /> CORRECTIVE ACTION: Ensure all designated operator inspection reports are completed and signed within the <br /> required time frame in the future. <br /> 2)OBSERVATION: The designated operator failed to check and note the correct test dates for the secondary <br /> containment test on the designated operator inspection reports. Secondary containment testing was conducted on <br /> 8/8/2016 and 8/26/2019. <br /> REGULATION GUIDANCE: During the inspection, the designated operator shall check that all required testing and <br /> maintenance for the UST system have been completed and document the dates they were done. <br /> CORRECTIVE ACTION: Ensure that designated operators performing inspections at this facility are including all of <br /> the required information on the reports. <br /> 3)OBSERVATION:The designated operator failed to check and note all required items on the visual inspection <br /> reports.The incorrect and missing information included the following from the inspection reports: <br /> -The"NA"in sections VII through XI were not explained. <br /> -Section VI of the report was missing the date, name, and signature of the UST owner/operator. <br /> -Tank and line tightness test information were left blank. <br /> -The question regarding UDC sensor location was answered"yes, "but the facility does not have any dispensers. <br /> REGULATION GUIDANCE: During the visual inspection,the designated operator shall check that all required <br /> testing and maintenance for the UST system have been completed and shall check all required items on the report. <br /> CORRECTIVE ACTION: Ensure that designated operators performing visual inspections at this facility are including <br /> all of the required information on the reports. <br /> This is a minor violation. <br /> Overall Inspection Comments: <br /> The monitoring system certification was conducted on 11/6/2019 and was not fully witnessed by EHD. Looked <br /> inside all sumps. Verified sensor locations. Verified spill bucket 5 gallon capacity. An inspection checklist was <br /> provided to the facility operator on the day of inspection. The EHD has written the complete report on 2/4/2020 <br /> 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 /> FA0002562 PR0231736 SCO01 11/06/2019 <br /> EHD 23-01 Rev.9/20/2019 Page 5 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 />