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Feb. 27. 2015 1:50PM A FACILITIES MGMT No. 916 P. 7 ACEIVED San Joaquin County 2015 Envlrohmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 t_, Telephone: (209) 468-3420,Fax. (200) 488-3433 W®b: s1Qozwgland 1—NVIRONMENTAL � Pb n! -OI rYrA q t NIT f. .?x-`A(y]� �� I[x■'�J).}.h'Rr.�y.:Y�]c�':{y4�■C� �'}`S." x]-'2'• y_.. '� 'a;D �a� r'c �� ' } S s'A? ' •..k. • .L. ��•`i:.y yT ••T•', i�,': !a`, : � .erF.6VC . ( a®ltltX Herne{ Facift Addros: pates SUTTER TRACY COMMUNITY HOSP 11420 N TRACY BLVD, TRACY November 21, 2014 •,:;�:,�. � `� a' � � "erg#""fir „o-�� [Wrn 0 Remarks co 32 Monitoring and response plans not current or approved by the EI -10, The monitoring pian Is not current and not approved by the EHp, Monitoring equipment should be listed as Veeder Root not Veteroot. Personnel responsibilities should list the hospital personnel assigned. The monitoring plan must be uploadedto the California EnVironmental Reporting System (CERS). Immediately log Into CERS, make the necessary changes, and submit for review by the EHD. This Is a minor violation. The response plan Is not current and not approved by the EHD. Response plan has not been uploaded into the California Environmental Reporting System. The response plan must be uploaded to the Californis Environmental Reporting System (CERS). Immediately log Into CERS, upload the completed form, and submit for review by the EI -11). Ensure a copy Is available for Inspeofion at any time. This Is is minor violation_ 107 CCR 2832(d)(1)(C) Pict pian/elte map not submitted or failed to completely show where. monitoring Is performed. An accurate UST Monitoring Site plan was not submitted. A site plan must be submitted identifying the Mations where monitoring will be performed, Immediately log into the California Environmental Reporting System (CERS) at http:l/c ar9-calepa,ce.gov1 and upload a copy of the UST Monitoring Site Plan, This is a minor violation. 126 HSC 26404(e)(4) felled to report program date electronically. A submission to the California Electronic Reporting System (CERS) for the underground storage tank (UST) program did not have the Owner Statement of Designated UST Operator Gomplicance nor Response Plan uploaded into CERS. Beginning January 1, 2014, all businesses are required to submit all now. (or any changes to existing) UST Information, Including: UST Monitoring Site Plan, UST businesses. of Financial Responsibility, UST Response Pian, UST Owner/Operator Written Agreement (if applicable), UST Letter from Chief Financial Officer, and Owner Statement of Designated UST Operator Compliance online to the CERS at http:llcsrs.calepa.ca.gov. Be sure to include any other relevant activities and required fields. This Is a repeat violation, Class II. Overall Inspection Comments: Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement documenting the corrective actions that have been or will be taken for each violation, and any supporting paperwork, by 12-21-14. Consent to perform the Inspection, take photos and collect samples was given by Pedro Gonzalez. This facility's designated operator Is David Winkler (iGC expiration date. 3-10-16). The service technician was David Winkler (ICC expiration date: 3-3-16), who had the following manufacturer's certificatlons: Veeder Root EXP. DATES 2-10-19 and SWRCB VXP DATES 3-3117. Please be aware that'as of January 1, 2014, facility operators are required to upload the following UST program documents into the California Environmental Reporting System (CERS): UST Monttodng Site Plan, UST Certification of Financial Responsibility, UST Response Plan, UST owner/Operator: Written Agreement (if applicable), LIST Letter from Chief Financial Officer, and Owner Statement of Designated UST Operator Compliance. . r Rec neps3c jr one: AR IS VF -1-080, Senior REHS (208) 466-3453 1112112014