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SAN JOAQUIN COUNTY <br /> qNVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.s*gov.org/ehd/unitiii.html <br /> CONTINUATION FORM Page: 3 of 3 <br /> OFFICIAL INSPECTION REPORT Date: 09-13-10 <br /> Facility Address: Kaiser Hospital 1777 West Yosemite Ave, Manteca Program: UST <br /> SUMMARY OF VIOLATIONS <br /> (CLASS t,CLASS II,or MINOR-Notice to Comply) <br /> UST Inspection: Annual Monitoring System Certification and Routine <br /> #6. Monitoring Plan not onsite. Monitoring Plan form can be found at http://www.sigov.org/ehd website. Correct <br /> by submitting a copy of the current Monitoring Plan to SJC EHD within 30 days (09/13/10). An approved copy will <br /> be sent back to the facility to be kept onsite at all times. <br /> #21. Liquid was found in the diesel STP sump. Per technician, it appears to have come from the oil filter. If liquid <br /> could enter into the secondary containment by precipitation or infiltration, facility shall have a means of monitoring <br /> for liquid intrusion and removing the liquid. Liquid must be analyzed for hazardous waste characteristics and <br /> disposed according to title 22 hazardous waste regulations at an authorized disposal facility. <br /> • Technicians removed the liquid and place liquid into their test liquid drum. <br /> #23c. DO monthly inspections has incorrect test dates. Designated operator documented on August— December <br /> 2009, January—April 2010 monthly reports last annual monitoring system certification was incorrectly <br /> documented as 08/01/09—actual date 08/07/09; Last spill containment/bucket test incorrectly documented as <br /> 08/01/09—actual date 08/07/09; Last line tightness test incorrectly documented as 08/29/08—actual date <br /> 12/24/08. November and December 2009 monthly reports incorrectly document secondary containment testing as <br /> 04/07/06. Submit how future documentation of test dates will be correctly written in the DO monthly reports. <br /> #23e. DO monthly visual inspections report not maintained onsite for at least 12 months. DO report for June and <br /> July 2010 not available for review. Facility must maintain the monthly reports onsite for at least 12 months. <br /> Correct by submitting a copy of the missing and July 2010 to SJC EHD within 30 days (09/13/10). <br /> #27. Annual line tightness test not conducted. Last line tightness testing was conducted 12/24/08. Monitoring <br /> shall be conducted on all underground pressurized piping with secondary containment at least annually at <br /> pressure designated by the equipment manufacturer. Correct by submitting line tightness test results to SJC EHD <br /> within 30 days (09/13/10). <br /> Submit to SJC EHD within 30 days (09/13/10): <br /> 1. one copy of the completed "Return to Compliance Certification"form <br /> 2. a corrective action statement for the above violations <br /> 3. requested or supporting documentations <br /> Notes: All future entry to hospital campus must check-in at the administration office <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE(FIZZ). <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TlMg AT EH 'S CURRENT HOURLY RATE. <br /> EHD Inspector:THUY TRA N Received By: Title: <br />