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i • <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.$)gov.org/ehd <br /> l�nderground StorageTank'Program l,ns <br /> pec tion-Report <br /> Facility Name: Facility Address: Date: <br /> LODI MEMORIAL HOSPITAL 975 S FAIRMONT AVE LODI October 16 2018 <br /> SUMMARY OF U T ONS t � <br /> w g ys 1c�ass 1,curse n,ci 4, �:: mpy) <br /> Item# Remarks <br /> 107 CCR 2632(d)(1)(C)Plot plan/site map not submitted or failed to completely show where monitoring is performed. <br /> An accurate UST Monitoring Site Plan was not submitted. The map does not include piping. A site plan must be <br /> submitted identifying the locations where monitoring will be performed. Immediately log into the California <br /> Environmental Reporting System (CERS)at http://cers.calepa.ca.gov/and upload a copy of the UST Monitoring Site <br /> Plan. <br /> This is a repeat violation, Class 11. <br /> 110 CCR 2637(e), 2637(f) Failed to submit"Secondary Containment Testing Report Form"within 30 days after the test. <br /> Secondary containment testing was performed on 10/24/17 and a test report was submitted on 12/7/17, one month <br /> late. A copy of the test report must be submitted within 30 days of the tests. Take all necessary precautions to <br /> ensure testing and submittal of test reports are performed in a timely manner. <br /> This is a minor violation. <br /> 202 CCR 2715(c)(3),2715(c)(4) Failure to maintain the"Facility Employee Training Certificate"on-site(after October 1, <br /> 2018). <br /> Designated operator training for two employees was conducted in October 2018 and the new form was not used. All <br /> training documentation should be done on the Facility Employee Training Certificate as of October 1, 2018. <br /> Immediately update the training to be documented on the correct form. <br /> This is a minor violation. <br /> 206 CCR 2712 Failure to comply with UST operating permit conditions. <br /> Work orders indicate that the S4 sensor was found to need replacement on 8/17/18 and was replaced on 10/2/18. <br /> The required documentation was not found on site for the technician or the testing. Immediately obtain a permit for <br /> this repair from the EHD. A failure to obtain a permit penalty may apply_ <br /> This is a repeat violation, Class IL �jt-{—\(�tL it `� api"IcI <br /> 209 CCR 2716(a-e)Failure to conduct the designated UST operator visual inspection at least once every 30 days. <br /> The designated operator inspection report was conducted on September 13, 2018 and again in October 2018, The <br /> October report was not documented on the new form. Immediately begin conducting all designated operator <br /> inspections using the required forms. <br /> This is a minor violation. <br /> till <br /> �='VITAL 8EALTk4 <br /> M"�ei*1 31 SCO01 10/16/2018 <br /> EH 23.01 Rev.09/22/16 Page 6 of 6 underground Storage Tank Program OIR <br />