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S A N ti�J O A Q U I N Environmental health Department 3k tl , Et ji j Ji - CCU NTY -- Aboveground Petroleum Storage Act Inspection Report Facility Name : Facility Address : [Dae :DAMERON HOSPITAL 525 W ACACIA ST , STOCKTON tober 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 Abandonment/Illegal 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 PRO526379 SCO01 10/25/2018 EHD 28-01 Rev. 09/27/2018 Page 4 of 7 Aboveground Petroleum Storage Act OIR 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468- 3420 F 209 464 -0138 1 www . sjcehd . com