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9 SAN JOAQUIN COUNTY 0 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.smq ov.or /g ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT CONTINUED <br /> Facility Dameron Hospital Facility 525 W. Acacia, Stockton InspDate: Feb 7, 2014 <br /> Name: Address: <br /> VIOLATIONS <br /> t702tCCR <br /> ection HSC=CA Health and Safe Code;CFR=Code of Federal Regulations <br /> C1=Class 1 violation;C2=Class 2 violation;M=Minor violation <br /> 3(e) Biennial tightness test of gravity piping not performed(pre-January 1, 1984) (M1) <br /> 3(d) Triennial line test for conventional suction piping not performed(pre-January 1, 1984) (M7) <br /> 999 Other:HSC 25404(e)(4) See attached"Continuation—Official Inspection Report"for violation(s)not listed above. <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> This is a Monitoring Certification and Routine inspection. The following are Minor violations Notice to <br /> Comply <br /> i�rIhu'� /%t e /�y1.�Vg f4�1` was 0-1s" Pere d Q �p,P,:-&-Y? /,.;'w;a.�l ' P . rze ` .PSC, <br /> 1 Fi nci res ns' 'lit c s ee rr f' c <br /> es n I * it en are quir to b sub d a al . Im edi ly s mit cop of <br /> f an r on ilit doc ent o the HD. Iterna ' el , log ' to C S, load e r quit <br /> Info ati , a su mit for revie by t e EH Com et by . eei,,4 4��� -eX �s elm g <br /> 204. The designated operator failed to check and note the correct test dates for the leak detector on the <br /> designated operator monthly inspection reports from January to November of 2013. During the <br /> monthly inspection, the designated operator shall check that all required testing and maintenance for the <br /> UST system have been completed and document the dates they were done. Ensure that designated <br /> operators performing monthly inspections at this facility are including all of the required information on <br /> the reports. <br /> 205. The December 2013 and January 2014 designated operator monthly inspection reports were not <br /> found on site. Designated operator monthly inspection reports for the previous twelve months shall be <br /> retained on site. Locate and ensure that copies of the previous twelve months of designated operator <br /> monthly inspection reports are maintained on site. Submit copies to the EHD by 3j ;x-/ 2t�14 e <br /> 999. HSC 25404 (e)(4). An account for California Environmental Reporting System (CERS) has not <br /> been obtained, and electronic reporting requirement has not been met. All business owners are <br /> required to submit their data from their CUPA hazardous materials programs (UST, hazardous waste <br /> generator) to the state electronically pursuant to AB2286. [Complete and submit a copy of the Return to <br /> Compliance Certification form with a statement of how each violation was corrected, including supporting <br /> documentation, by 3 I / oc`+-, <br /> 1?c�T�°`� ` a r► a// , /M.e�.e�►l�a��/ <br /> to f/►� s�,tl �ojr�u�•� ��11f4���, s c[ o �Kp .►� zfou� <br /> Q C�'Ks-P Cad'►fvzc( �o �!�' 'aYrn Ars- "r kf � - <br /> a <br /> e �rl�s <br /> ALL EHD STAFF TIME ASSOCIATED WI H FAILING TO C PLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REI PECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Inspector: Rec ii ed By: Title: <br /> EHD 02 Re 9/12 Page 3 UST INSPECTION REPORT <br />