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• • SKJ a A n U I N Environmental Health Department a C 0 U N�`t�`t'' Iii Underground Storage Tank Program inspection Report Facility Name: Facility Phone: Date: Sutter Valley Hospitals dba Sutter Tracy Community Hospital (209)835-1500 November 17, 2017 Facility Address: CERS ID: 1420 N Tracy Blvd,Tracy, CA 95376 10397599 Inspection Contact: Title: Phone: Mike Alva-Lopez Plants Operation Lead (209)833-5669 Inspection Type: Program: ROUTINE INSPECTION-Operating Permit 2361 -UST FACILITY Consent For: Consent Given By: x❑ Inspection x❑ Photos ❑ Samples Mike Alva-Lopez, Plant Operations Lead Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: Edward Stearns 11/09/2018 Felix Ramirez 02/26/2018 Service Technician Manufacturer's Training: Veeder Root, 08/09/19;Tank Tester, 09/30/20 CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations V=Violation R=Repeat violation COS=Corrected on site during inspection File Review 101 HSC 25284 Failure to obtain a valid permit to operate from the EHD including but not limited to unpaid fees D V n R ❑COS 102 HSC 25284(a)(3)(A)/(B) No written agreement between tank owner and tank operator to monitor the tank system D V D R D COS 103 HSC 25292.2,25299.30 Current financial responsibility documents not submitted D V ❑R D COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current D V D R D COS 105 CCR 2632(d)(1), Failed to have an approved UST monitoring plan ■V ■R D COS 2634(d) 106 CCR 2632(d)(2), Failed to have an approved UST response plan D V D R D COS 2634(e) 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ■V ■R D COS 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing D V D R D COS 109 CCR 2637 Failed to test secondary containment D V D R ❑COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days D V D R ❑COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually D V D R D COS 112 HSC 25284.2 Failed to test spill containers annually D V D R D COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days D V D R D COS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down D V D R D COS 115 CCR 2715(a) Failed to submit to EHD notification of designated operator identification or change w/in 30 days o V D R o COS 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification n V D R ❑COS 117 CCR 2663(h) Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after D V D R D COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests D V D R D COS 119 HSC 25299(a)(8), Documents were falsified or misrepresented D V D R D COS 25299(b)(7) 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification D V D R D COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ■V ■R ❑COS 122 CCR 26310) Failure to submit and maintain UST system component statement of compatibility for substance stored D V D R D COS On Site Records 201 CCR 2712(b) Failure to maintain monitoring,maintenance,and follow up action records D V D R D COS FA0002562 PR0231736 SCO01 11/17/2017 EHD 23-01 Rev.09/22/16 Page 1 of 5 Underground Storage Tank Program OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com