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S A J OAQ U I Environmental Health Department <br /> �. 0u N TY— <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> LODI MEMORIAL HOSPITAL 975 S FAIRMONT AVE, LODI October 22, 2019 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> Overall Inspection Comments: <br /> The monitoring system certification was conducted today(10/22/19), but was not witnessed in its entirety by <br /> EHD. Looked inside fill sumps, and turbine sump. Verified sensor locations. The paperwork inspection still <br /> needs to be conducted. A checklist was left on site today; a complete report will be provided at the time of <br /> paperwork inspection. <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received by: <br /> Date: October 22, 2019 Inspector: Inspector Phone: <br /> Printed Name and Title: PAUL NSO, EHS Trainee (209)468-3432 <br /> Tim Duncan, Facility Manager <br /> FA0000513 PR0231331 SCO01 10/22/2019 <br /> EHD 23-01 Rev.9/20/2019 Page 4 of 4 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />