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C <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.sigov.ora/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT CONTINUED <br /> FacilitName: SJ General Hospital ,Faadrless: 500 W Hospital Rd, French Camp batInse ectron Aug 24, 2012 <br /> VIOLATIONS <br /> # C1 C2 M code Section HSC=CA Heafth and Code;CFR=Code of Federal Regulations <br /> C1=Class 1 violation;C2=Class 2 violation;M=Minor violation <br /> Non-Pressurized Piping(continued) <br /> 702 CCR 2643(e) Biennial tightness test of gravity piping not performed(pre-January 1,1984) (M1) <br /> 703 CCR 2643(d) Triennial line test for conventional suction piping not performed(pre-January 1,1984) (M1) <br /> Other Violations <br /> 999 Other: See attached"Continuation—Official inspection Report"for violation(s)not listed above. <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS If,or MINOR-Notice to Comply) <br /> UST Inspection: Routine &Annual Monitoring System Certification <br /> 104. Financial responsibility documents for the year 2012 have not been submitted to the EHD. Current <br /> financial responsibility documents are required to be submitted annually. Complete and submit a copy <br /> of the financial responsibility: Certification Of Financial Responsibility and Letter from Chief Financial <br /> Officer. Repeat violation. <br /> Submit to SJC EHD within 30 days (09/24/12): <br /> 1. one copy of the completed "Return to Compliance Certification" form <br /> 2. copy of financial responsibility document <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Inspector: Received y: Title: <br /> / ( <br /> EHD 2302 1k4 D4/19/12 Page 3 UST INSPECTION REPORT <br />