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SAN J O QQ I I N Environmental Health Department <br /> y i� <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Sutter Valley Hospitals dba Sutter Tracy 1 1420 N Tracy Blvd, Tracy November 13, 2023 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS il,or MINOR•Notice to Comply) <br /> Item# remarks <br /> 208 CCR 2716(a-e) Failure to comply with the designated operator inspection requirements. <br /> 1). OBSERVATION: Designated operator reports were not signed within the required time frame. <br /> -The 8123/2023, 7/2612023, 510412023, 12/14/2022 and 11114/2022 designated operator reports were not signed by <br /> the owner/operator. <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 72 <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 /> ------------------------------------------------------------------------------------------------------------------------------- <br /> 2). 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 DO reports did not include the owner/operator name <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 repeat violation. Class II. <br /> Overall Inspection Comments: <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation. and any supporting <br /> paperwork, by 12/1312023 . <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate <br /> ($162). To schedule an appointment, please call (209) 468-3420. <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: <br /> Date: November 13, 2023 Inspector: Inspector Phone: <br /> Printed Name and Title: PAUL NSO, EH Specialist (209)616-3049 <br /> Emaii report to:Jason Simmons. Environmental Contact <br /> FA0002562 PR0231736 SCO01 11/1312023 <br /> EHD 23-01 Rev.1210612021 Page 5 of 5 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton California 952051 T 209 468-3420 I F 209 464-0138 I www sjgov org/EHD <br />