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2019 - 06 - 13 13055 ENGINEERING 2098253893 > > P 3 / 6
<br /> Environmental Health Department
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<br /> KAISER FOUNDATION - MANTECA 1777 W YOSEMITE AVE , MANTECA June 06 , 2019
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<br /> 123 CCR 2637 , 1 (d ), Failure to submit the "Spill Container Testing Report Form" within 30 days after the test ; V ;; R ' COS
<br /> 2637 . 10 PIVIPPIPIP
<br /> r 124 CCR 2637 .2(d & e ). to Preventinn Equipment Inspeolion Report Foran" not submitted within 30 days of inspectlon c V a R i COS
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<br /> 201 CCR 2,712(b ) Failure to maintain monlipring , maintenance, and follow up action records o V e: R o COS
<br /> 202 CCR 2715(C)(3 ), Pailure f0 maintain the " Facility Employee Training Certificate" onsite (a (t(sr October 1 , 2018) y n V to R a COS
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<br /> 203 CCR 2712 (b ) Failure to maintain records of repairs, lining , and upgrades on site , for the life of the UST u V ;:I R 1.I COS
<br /> 204 CCR 2712(i) Current monitoring plan approved by the EHD not found on site M M V R w COS
<br /> 205 CCR 2712(i) , 2634(e) Pallure to submit a current UST Response Plan and have it available onsiteV a R�ar.; COS^
<br /> 206 CCR 27 '12 nM a Failure tocomplywith UST operating permit conditions - is V r, R c COS
<br /> 207 HSC 25294 Failed to record unaulhorizod releaso from primary containment t:I V I;r R t; COS
<br /> 208 ~ CCR 2650(e ), 2652 Failod to notify the EHD of a reportable unauthorized release and/or prepare a report o V r.; R IN COS
<br /> 209 CCR 2716(a-o) u Failure to conduct the designated UST operator visuol inspection at least once every 30 days w n V rI R :; COS
<br /> 210 CCR 271 G(f) DO monthly reports not maintained on site for 12 months or for 36 months (after October 1 , 2018) o V t:r R o COS
<br /> 211 CCR 2715(c)(2 ) No employee present that were trained In the operation and maintenance of the UST system by a UO o V n R t, COS
<br /> 212 OCR 2715(1)(2 ) Unstaffed facility filled to novo or implement a training program approved by the EHD V � �; v c; R rl COS
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<br /> 213 FISC 25261 . 5 (b)(2) Unburind fool Dieing at marinas not visually Inspected at least daily or log not Keptn V ;a R COS
<br /> 214 HSC 25281 .6(b)(3) Unburied emergency generator fuel piping not visually inspooted at least monthly or log kept _ V n R COS
<br /> 216 CCR 2712(i ) Aµ Failure to relaln a ropy or the permit to operate at the facility :, V OR . COS
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<br /> ":: ' 111 PIP
<br /> 135 f'Systetn LDbservafip�s`
<br /> 301 11126292. 1 (a) UST system is not operated to prevent unaulhoriied release, including spills and overfills q V n R a COS
<br /> 302. HSC 25291 ( b) UST system incapable of detecting leak from primary into Secondary contairim0nt (pre-Jul 2003) r. V n R c COS
<br /> 303 HSG 25290 .2(d ) Monitoring system not maintained to detect entry into secondary containment (Jul 2003-Jun 2004 ) ::; V OR c1 COS
<br /> 304 NSC 25290. 1 (d ) Monitoring system not maintained to detect entry into secondary containment (after Jul 2004) c V n R n COS
<br /> 305 HSC 25290. 1 (e ) VPN monitoring of the interstitial spaces of the UST 3yRlerh is not maintoined w�- r., V ❑ R o COS
<br /> 306 CCR 2630(d ) Monitoring equipment is not Installed or maintained to detect a leak at the earliest opportunity r;; V u R c COS
<br /> 307 CCR 2631 (9 ), 2632(c) Monitoring system of the interstitial space of a double walled syktem not maintained c V o R r., COS
<br /> 308w CCR 2636(f) Failed to maintain a continuous monitorin(t System that activates an audible and visual alarm) :,: V ❑ R o COS
<br /> 309 OCR 2636(f)( 1 ) u w Monitoring 1n Sump I UDC failed to activate an audible and visual alarnn or slop the flow product�� r. V n R ❑ COS
<br /> 310 r CCR 2636(f)(4 ) Piping is not fail-safe outside UDCs or fails to Stop flow of product at dispenser inside (Il k , V :, R ,) COS w
<br /> 311 CC17 2636(x ), 2641 (j) Failed to properly program , calibrate , operate, or maintaln teak detection equipment ~~ On V n R c: COS
<br /> 312y CCR 2638(f). 2641 (1 ) railed to affix a tag sticker on monitoring muloment Certified, repaired, or replaced : V ti R ; COS
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<br /> 3613 HSC 25290 . 1 , 25280.2, Failure to construct, operate, and maintain primary containment %is product-G(ittl ~ ~ M y w :; V ci R t, COS
<br /> FA0003978 PR0232397 SCO01 06/06/2019
<br /> CHD 23-01 Rev, 09/28/2019 Pago 2 of 5 UnaoMround Stersge 'rank Program OIR
<br /> 1868 E . Hazelton Avenue Stockton , California 96205 T 209 468- 3420 1 F 2. 09 } 64 -0138 www . sjcehd . corn
<br /> Received Time Jun , 11 2019 1 : 48PM No , 5150
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