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S A N J 0 A Q I I I Irl Environmental Health Department <br /> CCUNT <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> ST JOSEPHS HOSPITAL 1800 N CALIFORNIA ST, STOCKTON September 27, 2021 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 209 CCR 2715(c)(3), 2715(c)(4) Failure to maintain a copy of the"Facility Employee Training Certificate"on-site. <br /> OBSERVATION: The Facility Employee Training Certificate dated 11/18/2020 was missing the following items: <br /> -CERS ID <br /> -Facility street address&zip code <br /> -Initial training date and date of assuming responsibility as a facility was documented as 11/18/20. On the <br /> 10/26/2020 training form dates were listed as 10/9/2019 for initial training date and date of assuming responsibility. <br /> REGULATION GUIDANCE:All site employees must be trained prior to taking responsibility as a facility employee if <br /> after October 1, 2018, or within 30 days of hire if prior to October 1, 2018. The Facility Employee Training <br /> Certificate shall contain accurate information for all employees trained. <br /> CORRECTIVE ACTION: Update the Facility Employee Training Certificate to contain the accurate information and <br /> submit a copy of the updated form to the EHD. <br /> This is a repeat violation, Class II. <br /> Overall Inspection Comments: <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by October 27, 2021. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate <br /> ($152). To schedule an appointment, please call (209)468-3420. <br /> Documents provided during inspection: Return to Compliance certification, flyer for free CUPA classes <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: Date: September 27, 2021 Inspector: Inspector Phone: <br /> Printed Name and Title: LYDIA BAKER, REHS (209)616-3046 <br /> Emailed to Charles Chapple,Assistant Chief Engineer <br /> FA0003761 PR0231036 SCO01 09/27/2021 <br /> EHD 23-01 Rev.9/16/2020 Page 6 of 6 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.sjgov.org/EHD <br />