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SAN J O A R N Environmental Health Department <br /> i y �V <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> LODI MEMORIAL HOSPITAL 975 S FAIRMONT AVE, LODI October 22, 2019 <br /> Other Violations <br /> 2010 See below Unlisted General violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 105 CCR 2632(d)(1), 2634(d)Failed to have an approved UST monitoring plan. <br /> OBSERVATION: The monitoring plan is not current and/or not approved by the EHD. <br /> -Under"Record keeping",the monitoring plan for the 20, 000 gallon diesel tank incorrectly states that the site keeps <br /> records of Tank Integrity testing results. <br /> REGULATION GUIDANCE: The monitoring plan must be uploaded to the California Environmental Reporting <br /> System (CERS). <br /> CORRECTIVE ACTION: Immediately log into CERS, make the necessary changes, and submit for review by the <br /> EHD. <br /> This is a repeat violation, Class II. <br /> 113 CCR 2638(c), 2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the <br /> test. <br /> OBSERVATION:Annual monitoring system certification, leak detector testing, and spill container testing was <br /> performed on 10/16/2018 and a test report was submitted on 1/8/2019, 1 months late. <br /> REGULATION GUIDANCE:A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are <br /> performed in a timely manner. <br /> This is a repeat violation, Class II. <br /> 124 CCR 2637.2(d&e), 2665(a&b)"Overfill Prevention Equipment Inspection Report Form" not submitted within 30 days <br /> of inspection. <br /> OBSERVATION: Overfill Prevention Equipment Inspection was performed on 10/16/2018 and a test report was <br /> submitted on 5/16/2019, 6 months late. <br /> REGULATION GUIDANCE:A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are <br /> performed in a timely manner. <br /> This is a minor violation. <br /> FA0000513 PR0231331 SCO01 10/22/2019 <br /> EHD 23-01 Rev.9/20/2019 Page 4 of 7 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />