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AEk r --I San Joaquin County low Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd Underground Storage Tank Program Inspection Report Facility Name: Facility Address: 1 Date: SUTTER TRACY COMMUNITY HOSP 1420 N TRACY BLVD, TRACY November 21, 2014 SUMMARY OF VIOLATIONS (CLASS I, CLASS II, or MINOR- Notice to Comply) Item # Remarks 106 CCR 2632 Monitoring and response plans not current or approved by the EHD. The monitoring plan is not current and not approved by the EHD. Monitoring equipment should be listed as Veeder Root not Veteroot. Personnel responsibilities should list the hospital personnel assigned. The monitoring plan must be uploaded to 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 California Environmental Reporting System (CERS). Immediately log into CERS, upload the completed form, and submit for review by the EHD. Ensure a copy is available for inspection at any time. This is a minor violation. 107 CCR 2632(d)(1)(C) Plot plan/site 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 locations where monitoring will be performed. Immediately log into the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov/ and upload a copy of the UST Monitoring Site Plan. This is a minor violation. 126 HSC 25404(e)(4) Failed to report program data 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 Complicance nor Response Plan uploaded into CERS. Beginning January 1, 2014, all businesses are required to submit all new (or any changes to existing) UST information, including: UST Monitoring Site Plan, UST Certification of Financial Responsibility, UST Response Plan, 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://cers.calepa.ca.gov. Be sure to include any other relevant activities and required fields. This is a repeat violation, Class 11. 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 (ICC expiration date: 3-10-16). The service technician was David Winkler (ICC expiration date: 3-3-16), who had the following manufacturer's certifications: Veeder Root EXP. DATES 2-10-16 and SWRCB EXP DATES 3-31-17. 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 Monitoring Site Plan, UST Certification of Financial Responsibility, UST Response Plan, UST Owner/Operator: Written Agreement (if applicable), UST Letter from Chief Financial Officer, and Owner Statement of Designated UST Operator Compliance. Phone: Date: TAnspector: RIS VELOSO, Senior REHS (209) 468-3453 11/21/2014 Pana d of S