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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.slgov.org/ehd/unitiii.html <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT CONTINUED <br /> Facility Dameron Hospital Facility 525 W. Acacia Stockton Inspection Feb 10, 2012 <br /> Name: p Address: + Date: <br /> VIOLATIONS <br /> # C1 C2 M I Code Section HSC=CA Health and Safety Code;CFR=Code of Federal Regulations <br /> C1=Class 1 violation;C2=Class 2 violation;M=Minor violation <br /> h Non-Pressurized Piping(continued) �F t <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 /> 4 r. Other Violations ) <br /> 999 Other: See attached"Continuation—Official Inspection Report"for violations)not listed above. <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> This is an annual Routine inspection and annual Monitoring Certification inspection. <br /> No violation was observed during this inspection. <br /> NOTES <br /> Observed technician performed annual line test on site; passed. Technician certification is Petro Tite <br /> Line Test CAA0203032811 C expire on 5/3/2013. <br /> Received a copy of the Secondary Containment Test Report conducted on 01/12/2012 on site. <br /> Technician and Jacob stated UST training for employee by designated operator was completed today <br /> (training is due on 2/16/2012). Jacob will send training signed off log to EHD when completed. <br /> Please be aware your financial responsibility documents are due by 2/23/2012. <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> TH F CILITY IS SUB CT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Inspe or - � ceived By: Title: <br /> EHD 2 -02 . ev 1l1 Page 3 UST INSPECTION REPORT <br /> ,r' <br />