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SHARON <br /> HARON Environmental Health Department <br /> COUNTY <br /> nderground Storage Tank Pr3 Iilt:Report <br /> Facility Name: Facility Address: Date: <br /> LODI MEMORIAL HOSPITAL 975 S FAIRMONT AVE, LODI October 26, 2017 <br /> SUMMARY OF t0 NS <br /> (CLA`SS I,CLASS 11,or fJ11ItOR Notice to Comply) <br /> Item# Remarks <br /> 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan. <br /> The monitoring plan is not current and/or not approved by the EHD. Monitoring plan is lacking brine sensors. The <br /> monitoring plan must be uploaded to the California Environmental Reporting System(CERS). Immediately log into <br /> CERS, make the necessary changes, and submit for review by the EHD. <br /> This was corrected on site. <br /> This is a repeat violation, Class Il. <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. Site plan is lacking locations of smart sensors and brine <br /> sensors.A site plan must be submitted identifying the locations where monitoring will be performed. Immediately <br /> log into the California Environmental Reporting System(CERS)at http://cers.calepa.ca.gov/and upload a copy of <br /> the UST Monitoring Site Plan. <br /> This was corrected on site. <br /> This is a minor violation. <br /> 206 CCR 2712 Failure to comply with UST operating permit conditions. <br /> The S3 vent line vacuum sensor was replaced'like for like"on 6/27/2017 and no notification was received by EHD. <br /> Emergency repairs relating to UST system monitoring and release detection may be performed by a properly <br /> licensed,trained, and certified contractor pursuant to the EHUS policy and a permit obtained within one business <br /> day from the EHD. All other repairs must have a permit submitted to and approved by the EHD prior to beginning <br /> work. Immediately obtain a permit from the EHD for the S3 vent line vacuum sensor replacement. A"Failure to <br /> Obtain a Permit'penalty applies. <br /> This is a minor violation. <br /> Overall Inspection Comments: <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by November 25, 2017. <br /> Please be aware that as of January 1, 2014, facility operators are required to upload the following UST program <br /> documents into the California Environmental Reporting System (CERS): UST Monitoring Site Plan, UST <br /> Certification of Financial Responsibility, UST Response Plan, UST Letter from Chief Financial Officer(if <br /> applicable), and the Owner Statement of Designated Operator Compliance. The UST Owner/Operator: Written <br /> Agreement, if applicable, can be stored at the facility or uploaded into CERS. <br /> Documents reviewed: Employee training log, monitoring system certification reports, secondary containment <br /> reports, permit, financial documents, D.O. monthly inspection reports, maintenance records, monitoring plan, <br /> FA0000513 PR0231331 SCO01 10/26/2017 <br /> EHD 23-01 Rev.09/22/16 Page 4 of 5 Underground Storage Tank Program OR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />