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SANJ O 1` Q U I `IA,II, Environmental Health Department COUNTY Aboveground Petroleum Storage Act Inspection Report Facility Name: Facility Address: Date: DAMERON HOSPITAL 525 W ACACIA ST, STOCKTON October 25, 2018 Other Violations 4020 See below Unlisted Training violation ❑V ❑R ❑COS 4030 See below Unlisted Operations/Maintenance violation ❑V ❑R ❑COS 4040 See below Unlisted Release/Leaks/Spills violation ❑V ❑R ❑COS 4050 See below Unlisted Abandon ment/lIlegal Disposal/Unauthorized Treatment violation ❑V ❑R ❑COS SUMMARY OF VIOLATIONS (CLASS I,CLASS II,or MINOR-Notice to Comply) Item# Remarks 103 HSC 25270.6(a)Failed to file HMBP or annual facility tank statement. A tank facility statement or business plan was last submitted on 02/17/2017.A tank facility statement identifying the name and address of the tank facility, a contact person for the tank facility, the total storage capacity of the tank facility, and the location, size, age, and contents of each storage tank that exceeds 10,000 gallons in capacity and that holds a substance containing at least 5 percent of petroleum shall be submitted annually. Submittal of a business plan satisfies the requirement to submit a tank facility statement. Immediately submit a tank facility statement or business plan. Note: To meet the requirement by submitting a business plan,you must submit the Facility Information, Hazardous Materials Inventory, Site Map and Emergency Response and Training Plans submittal elements through CERS.To indicate that you are using your business plan to meet the APSA reporting requirement, select the Provided Elsewhere in CERS document option, select Hazardous Materials Inventory, then click the Save button. This is a Class II violation. 302 CFR 112.5(b) Failed to review Plan once every five years and/or implement any resulting amendments. The Spill Prevention, Control, and Countermeasure(SPCC)Plan was last reviewed on March 31, 2011. A review and evaluation of the SPCC Plan must be conducted at least once every 5 years. As a result of this review and evaluation,the SPCC Plan must be amended within 6 months of review, and recertified by a Professional Engineer if any technical amendments were made. Immediately conduct a review of the facility SPCC Plan and make any necessary amendments. This is a Class II violation. 601 CFR 112.7 Failure of Plan to fulfill basic requirements including a cross-referencing section. The Spill Prevention, Control, and Countermeasure(SPCC)Plan does not follow the order or requirements in 40 CFR Part 112, and a cross-reference was not provided. If you do not follow the sequence specified in 40 CFR 112 for the Plan, you must prepare an equivalent Plan and supplement it with a section cross-referencing the location of requirements in 40 CFR 112 and the equivalent Plan. Immediately amend the SPCC Plan to include a cross-reference or to follow the required sequence. This is a minor violation. FA0002864 PR0526379 SCO01 10/25/2018 EHD 28-01 Rev.09/27/2018 Page 4 of 7 Aboveground Petroleum Storage Act OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com