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SANAAQUIN Environmental Health Department <br /> COUNTY— <br /> IV4 <br /> n er n"eiii <br /> hu 0 : <br /> _W, 00 0tronRepor <br /> Facility Name: Facility Address: Date: <br /> LODI MEMORIAL HOSPITAL 975 S FAIRMONT AVE, LODI October 26,2017 <br /> USTSyste'J <br /> pser <br /> no" <br /> 321 CCR 2635(b)(2) Overfill prevention was overridden o V c R o COS <br /> 322 HSC 25281.6(a) Unburied below grade emergency generator system failed to meet exemption status u V c R o COS <br /> 323 HSC 25283.5(a) Unburied below grade UST system failed to meet exemption status o V o R o COS <br /> 324 CCR 2717.1(g) Tampered with red tag o V c R o COS <br /> 325 CCR 2717.1(f) Deposited petroleum into a red tagged UST Ei V o R o COS <br /> 326 HSC 25299(a)(9) Tampered with or disabled leak detection devices or alarms o V ii R o COS <br /> 327 CCR 2631.1 UST system not compatible with the substance stored o V o R u COS <br /> 328 HSC 25298 Failed to comply with temporary closure requirements ii V o R o COS <br /> 329 HSC 25298 Failed to comply with permanent closure requirements u V o R o COS <br /> 330 CCR 2636(f)(6) Failure to meet all requirements in lieu of a line leak detector for emergency generator tank system 1:1 V c R o COS <br /> a. <br /> 36 <br /> Aqal[k6d Non-PressurizedjppkV, <br /> 401 CCR 2636(a)(3) Suction piping not properly sloped or incorrectly located check valve o V D R ii COS <br /> 402 CCR 2643(d) Daily monitoring of suction pipe(pre-Jan 1984)not performed ii V c R o COS <br /> 403 CCR 2643(d) Triennial 0.1 gph line test for conventional suction piping not performed(pre-January 1984) o V Ei R o COS <br /> 404 CCR 2643(e) Biennial 0.1 gph test for gravity piping not performed(pre-January 1984) o V o R o COS <br /> Vildl <br /> 2010 See below Unlisted Administration/Documentation violation ❑V o R ii COS <br /> 2030 See below Unlisted Operations/Maintenance violation Ei V Ei R Ei COS <br /> 2060 See below Unlisted Design/Construction violation o V Ei R c COS <br /> hi <br /> W" <br /> ',0FV1( <br /> V_ <br /> ((CLASS 1,6LAS$)[,�or Al OR��i'NoticeA6 Cdrnply)-�:r J,Z3. <br /> Item# Remarks <br /> 103 HSC 25292.2 Current financial responsibility documents not submitted. <br /> Financial responsibility documents have not been submitted to the EHD. Current financial responsibility documents <br /> are required to be submitted annually. Immediately log into the California Environmental Reporting System(CERS) <br /> at hftp://cers.calepa.ca.gov/, and upload the required documents. <br /> This was corrected on site. <br /> This is a repeat violation, Class II. <br /> FA0000513 PR0231331 SCO01 10/26/2017 <br /> EHD 23-01 Rev.09/22/16 Page 3 of 6 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 />