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Home My WebLink About5201 WHITE LN CUPA REPORT 11.19.14BAKERSFIELD FIRE DEPARTMENT Prevention Services Division Underground Storage Tank Program 2101 H Street DW Inspection 1�teport Bakersfield, CA 93301 Permission to Inspe ----Rbone: 661-326-3979 Fax:' -661 -852 -2171 Business Name: good samaritan hospital southwest -15- 021 - 003638 Date: 11119/2014 Address Name: 5201 white lane- I Inspector Name: Shane Gardner #8248557 Inspection Type: Routine �]LReport: Final NVO = No Violation Observed OUT = Out of Compliance NA = Not Applicable UD = Undetermined COS = Corrected On Site RPT = Repeat Violation Violation Program Requirement 4 C 6 0 41 SOC Comments No 9. 0 = '02 C 0 a IM I z 0 z File Review Facility Tank Information 2030021 Facility has a valid Permit Tank 1 -1 000-DSL-DW to Operate from the Tank 2- CUPA - 23 CCR 16 2712(1); None Tank 3- HSC 6.7 25284 Tank 4- 2010010 UST Operating Permit Application for Facility information and Tank information ❑ El None submitted/maintained 23 CCR 16 2711; HSC 6.7 25286(a) 2010001 Current BOE number submitted to the CUPA. ❑ ❑ ❑ r-1 ❑ None and/or CERS - HSC 6.7 25286(c) 2030011 UST compliance statement and/or Designated Operator ❑ E-1 ❑ ❑ ❑ None current certification submitted - 23 CCR 16 2715(a), 2715(b) 2030046 A complete and accurate response plan has been submitted, approved and None maintained - 23 CCR 16 2632, 2634(e), 2641(h), 2712(i) 2030041 A complete and accurate plot plan has been submitted, approved and 0` ❑ ❑ ❑ ❑ ❑ None maintained - 23 CCR 16 2632(d)(1)(C), 2711(a) 2010006 Owner/Operator has not made false statements or representation on any ❑ ❑ ❑ ❑ ❑ None required document - HSC 6.7 25299 00 2010003 Owner/Operator has a DO and/or informed the CUPA of any change (s) 0� ❑ ❑ ❑ ❑ ❑ None within 30 days - 23 CCR 16 2715(a) Violation Program Requirement 4- 0 4) = 0 SOC Comments No 0 0 (L 42 Z 0 z :3 > Testing 2030002 Owner/Operator has tested and certified leak )2' El ❑ ❑ ❑ ❑ None detection equipment annually - 23 CCR 16 2638 2030048 Secondary containment testing conducted every 36 months in accordance None with requirements - 23 CCR 16 2637 2030055 Spill buckets have been tested annually as rEFJ ❑ ❑ ❑ ❑ None required - HSC 6.7 25284.2 2010009 Secondary containment test results submitted to the CUPA within 30 days ❑ ❑ None after the test - 23 CCR 16 2637(e) 2030064 CUPA was poperly notified within the prescribed number of ❑ ❑ ❑ ❑ ❑ None hours prior to testing - 23 CCR 16 2637(0, 2638(e), 2643(8), 2644.1(a)(4) Install/Repair 2060009 Permits obtained to install, replace, repair, or R FIE] ❑ None modify part of the UST system - 23 CCR 16 2712 'Observation UST System General Monitoring 2030003 Leak detection system maintains continuous RD monitoring that activates ❑ ❑ ❑ None [:1 an audible and visual Yes alarm - 23 CCR 16 2632, 2634, 2636, 2666 2030016 The annular space of the tank, piping and sumps RD are continuously monitored and activates ❑ ❑ ❑ F-1 None ❑ the alarm - 23 CCR 16 Yes 2631(g), 2632(c)(2)(A)&(8), 2633(c), 2636(o 2030017 Product piping outside the UDC is fail-safe and shuts down the pump or None restricts flow - 23 CCR 16 2636(0(5) 2030018 Turbine sump monitor RD activates an audible and visual alarm or stops the ❑ ❑ ❑ None ❑ flow of at the dispenser - Yes 23 CCR 16 2636(0(1) jj Underground Storage Tank Program - DW Inspection Report v 2.0 Violation Program Requirement 0 0 SOC Comments No D Q o O a �o z O z M 0 W oy 2030019 Monitoring system in the UDCs activates an FO audible and visual alarm ❑ ❑ ❑ ❑ None or stops the flow at the UDC - 23 CCR 16 2636(0(1)__ 2030043 Leak detection equipment RD properly programmed or properly operated - 23 ❑ ❑ ❑ ❑ ❑ None ❑ CCR 16 2632, 2634, 2636, Yes 2666 2060005 System constructed with a monitoring system capable of detecting entry ❑ ❑ ❑ ❑ ❑ None into secondary containment - HSC 6.7 25291 b 2060014 Correct leak detection equipment installed for RD the type of system ❑ ❑ ❑ [] ❑ None ❑ present - 23 CCR 16 2638; Yes HSC 6.7 25290.1, 25290.2, 25291 2060015 Sensor located in the RD proper position /location - ❑ ❑ ❑ [] ❑ None ❑ 23 CCR 16 2630(d), 2641(x) Yes 2030062 Facility is in compliance RD with not tampering with or disabling leak detection ❑ ❑ ❑ ❑ ❑ None ❑ devices or alarms - HSC Yes 6.7 25299 a (9 2060022 System constructed with a monitoring system capable of detecting entry ❑ ❑ ❑ ❑ ❑ None into secondary containment - HSC 6.7 25290.2(d) 2030034 Tag /sticker on affixed monitoring equipment being certified, repaired, ❑ ❑ ❑ ❑ '❑ None or replaced - 23 CCR 16 26380 VPH Monitoring VPH 2030065 Interstitial monitoring of RD the annular spaces of the UST is properly ❑ ❑ ❑ ❑ ❑ None maintained - HSC 6.7 Yes 25290.1 e 2060023 System constructed with a monitoring system capable of detecting entry into secondary ❑ ❑ ❑ ❑ ❑ None containment - HSC 6.7 25290.1(d) Underground Storage Tank Program - DW Inspection Report v 2.0 Violation Program Requirement 4- 0 0 SOC Comments No a 0 CL Z 0 Z I M U > Line Leak Detector 2060012 Line leak detector installed on pressurized RD piping system - HSC 6.7 ❑ ❑ ❑ None ❑ 25290.1(h), 25290.2(8), Yes 25291(0, 25292(e), 2636(1) (2) 2030026 Line leak detectors detect a 3 gph leak and/or RD audible and visual alarm RE] ❑ None ❑ function properly - 23 Yes CCR 16 2636(0(6), 2666(c) 2030027 Turbine shuts down when RD a leak is detected or when line leak detector is ❑ ❑ ❑ ❑ ❑ None [--j disconnected - 23 CCR 16 Yes 2666 2030025 Pressurized piping able to detect a 3.0 gph leak RD within an hour, and FJ El ❑ ❑ ❑ None ❑ restricts the flow or Yes alarms - 23 CCR 16 2636(0(2) Secondary Containment 2060010 UST storing a hazardous RD substance has secondary None [:1 containment - HSC 6.7 Yes 25292 1 Underground Storage Tank Program - DW Inspection Report v 2.0 Violation Program Requirement 0 0 SOC Comments No 4 a CO 0 0. 2 0 Z > 2030008 UDC, sumps, and/or other secondary containment in good A None condition and/or are free of debris/liquid - HSC 6.7 25290.1, 25290.2, 25291 2030040 Secondarily contained RD piping maintained to allow ❑ ❑ ❑ ❑ ❑ None ❑ liquid to drain into sump - )D Yes 23 CCR 16 2630(d), 2641 (a) , 2060006 Secondary containment piping slopes back to the None collection sump - 23 CCR /1�1 16 263(c) 2030047 Secondary containment maintained tight and has been confirmed by testing ❑ ❑ ❑ ❑ ❑ None - 23 CCR 16 2662; HSC 6.7 /E] 25290.1(c)(2), 25290.2(c)(2), 25291(a), 25292(e) 2030060 Entry fittings in secondary containment for UST system maintained None tight/sealed - 23 CCR 16 2630, 2635(d), 2636(c), 2666 2060020 Spill bucket is installed RP and has a functional drain valve or other means to None ❑ remove liquid - 23 CCR 16 Yes 2635(b), 2665 2030054 Spill bucket maintained in RP good condition and free of ❑ ❑ ❑ ❑ ❑ None ❑ debris and/or liquid - 23 Yes CCR 16 2635(b), 2715(c)(2) 2060019 Spill bucket to has a minimum capacity of five ❑ ❑ None gallons - 23 CCR 16 2635(b), 2665 Overfill 2030035 UST system is operated RP to prevent unauthorized release, including spills ❑ El 1:1 1:1 ❑ None ❑ and overfills - HSC 6.7 Yes 25292.1 (aj 2030036 Overfill prevention system RP has not been overridden and meets overfill E:] ❑ ❑ None F1 requirements - 23 CCR 16 Yes 2635(b)(2), 2665 Underground Storage Tank Program - DW Inspection Report v 2.0 Violation Program Requirement %A- 00 .0 SOC Comments No ::�. F- < a 0 CL 0 z 0 z M On Site Records Certifications 2030023 Required designated operators or contractors maintain a proper and ❑ ❑ ❑ ❑ ❑ None current ICC certification - 23 CCR 16 2715 2030024 Service technician, installer, and/ or employee maintain a ❑ F-1 ❑ None proper license - 23 CCR 162715 2030031 Employee or contractor obtained and maintained proper manufacturer None certification - 23 CCR 16 2715 2010007 Submit/maintain current Certificate of Financial Responsibility/mechanism of financial assurance - El El 0 ❑ E] None 23 CCR 16 2711; 23 CCR/E) 18 2808.1, 2809-2809.2, HSC 6.7 25292.2; HSC 6.75 25299.30-25299.34 Designated Operator 2010004 Copies of DO inspections for last 12 months and list of trained employees 0 ❑ None maintained - 23 CCR 16 /Of 2715 2030013 Designated operator properly conducted the monthly inspection and I ❑ ❑ ❑ ❑ ❑ None the reports are complete - 23 CCR 16 2715 2030010 DO notified operator of any condition observed during the monthly ❑ ❑ ❑ None inspection that may require action - 23 CCR 16 2715(o) 2030012 DO employee training performed, current for at least one employee on F-1 ❑ None site, and a log kept - 23 CCR 16 2715(c)(6), 2715(0 Underground Storage Tank Program - DW Inspection Report v 2.0 Violation Program Requirement 4- 0 0.0 SOC Comments No In 0 0. 0 W %. cc 0 Z 0 Z D 0 W Logs 2030001 Leak detection alarm logs, maintenance and RD records of appropriate ❑ ❑ [:j ❑ ❑ None ❑ follow-up actions Yes maintained - 23 CCR 16 2632, 2634, 2712(b) Maintenance/Tests 2010008 Monitoring, maintenance, repairs, linings, and RD upgrade records r_1 El El El F-1 None R maintained for the proper Yes time period - 23 CCR 16 2712(b Documentation 2030033 Failure to maintain on site an approved monitoring ❑ ❑ ❑ FIR None plan - 23 CCR 16 2632, 2634, 2711, 2712(i) 2030037 Written agreement between the tank owner and tank operator to monitor the tank system Fzf ❑ ❑ E:i ❑ ❑ None is maintained - 23 CCR 16 2620(b); HSC 6.7 25284(a)(3) 2030061 Suspected or actual unauthorized release RD reported in appropriate ❑ ❑ None ❑ time frame - HSC 6.7 Yes 1 29294,29295 General Operating Requirements Permit Condition/Approval 2030039 Compliance with all operating permit ❑ ME] None conditions - 23 CCR 16 2712, HSC 6.7 25299 2030059 UST system maintained in accordance with exclusion/exemption ❑ ❑ ❑ None status - HSC 6.7 25281.6, 25283.5 2030014 Owner/Operator received approval and has implemented a training ❑ ❑ ❑ ❑ ❑ None program at an unstaffed facility - 23 CCR 16 2715(0(?) 2030015 Facility exhibited that the method used to monitor the tank meets the monitoring methods in ❑ ❑ ❑ ❑ ❑ None 2643(f) - 23 CCR 16 2643 Underground Storage Tank Program - DW Inspection Report v 2.0 Violation Program Requirement 4- 0 0 4) = SOC Comments No a 0 0. P Z 0 z M 0 W 0> Red Tag 2030045 Red Tag information is legible and has not been ❑ ❑ E ❑ None tampered with - 23 CCR 16 2717.1 (g) 2030044 Facility did not allow for deposit of petroleum into a UST that has a red tag ❑ ❑ None affixed to the fill - 23 CCR 162717.1(0 Install/Repair 2060024 UST system is made of or lined with materials that are compatible with the None substance stored - 23 CCR 16 2631.1 2060021 Striker plate installed and positioned correctly - 23 F-1 ❑ None I CCR 16 2631(jc, 2662(d) here were no violations noted for this inspection. ❑This report shall serve as a "NOTICE TO COMPLY" for Minor Violations, and a "NOTICE OF VIOLATION" for Major violations. You are, hereby, ordered to correct the above noted violations within 30 days, or according to correction summaries provided. Formal enforcement and/or penalty assessment may be initiated for any violations noted, and for those not corrected in a timely manner. (NOTE: If this is a preliminary report, a final report will follow.) Inspectors Signature: -Z—Z, Date: 00 Inspector: Enter # of Violations: RD: RP: �'3 Check one box for facility Significant Operational Status (SOC) to be reported to SWRCB and US EPA: Ua'$bC with both Release Detection and Release Detection (Facility has no Release Prevention and no Release 1P-revention violations) ❑ Not in SOC (Facility has both Release Prevention and Release Detection Violations) ❑SOC with Release Detection only (Facility has no Release Detection violations but one or more Release Prevention violations) ❑ SOC with Release Prevention only (Facility has no Release Prevention violations but one or more Release Detection violations Underground Storage Tank Program - DW Inspection Report v 2.0