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PUBLIC HEALTH SERVICES SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E. Weber Ave. , Third Floor, Stockton, CA 95202 <br /> (209) 468-3420 <br /> UNDERGROUND STORAGE <br /> . TANKI (UST) PROGRAM INSPECTION REPORT <br /> Facility Name dre.o ! C/ Program ID# i JA 6' <br /> Facility Address 6- C:—, City S���C'� �'{� Zip %-5 <br /> UST: Dual Wall Single Wall ><- Audible VisualMechanical <br /> PIPING SYSTEM: Dual wall Single wallSuction Pressure_ Gravity <br /> DOES THE LEAK DETECTION SYSTEM meet 23CCR 636 (8) requirements? YES NO� <br /> VIOLATIONS <br /> UST GENERAL REQUIREMENTS TANK # <br /> Permit to Operate [H&SC 252841 <br /> Forms A & B Current H&SC 25284 c <br /> Monitoring/Maintenance Records 23CCR 2712 b <br /> Financial Resnongihility FN&SC 2S292 2 (a) ] <br /> Monitoring Records Available 23CCR 2712 <br /> Monitoring Plan [23CCR 2632 (d) (1) ] <br /> Resnonse Plan [23CCR 2632 (d) (2) 1 <br /> Unauthorized Releases Reported [H&SC 25295] <br /> Monitoring Equipment Annual Cert. 23CCR 2630 <br /> ver siDili ConEainer <br /> Cathodic Protection 23CCR 2635 a 2 A <br /> New USTs Monitored Continuously [23CCR 2630] <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Meters r 23CCR 2 4 i <br /> Gauaina Stick in 1�8 Inches [23CCR 2e�G (c) (1) (F) i <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-variation Proceaure Foilowed L23CUR 2646 (e) ]- <br /> STATISTICAL <br /> Inconclusive Procedure Followed [23CCR 2646 .1 (d) ] <br /> UST Integrity Test Every Two Years 23CCR 2646 .1 <br /> Annual SIR Report [23CCR 2646 .1 (j) ] <br /> Daily Stick Reading c <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> Annuai ATG Summary Report <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> nuai 'I'ank integrity es 5 <br /> anGauging ProcecLure Poiiowect <br /> PING MONTTORINrZ <br /> Daily Suction Piping Monitoring r2 R Alpy. III <br /> Piping Ticrhtness Test 23CCR 2643 b c d <br /> Gravity Piping Tested Every 2 Years [23CCR 2643 (e) ] <br /> Monthly Line Test L23CCR 2643 c 2 <br /> uai Eeak 1)efector <br /> TANK REMOVAL <br /> Permit to Close or Cease Operation H&SC 25298 <br /> Removed, ciosecl or Temporar y Closed 23CCR 2670 <br /> REHS INSPECTION DATE/TYPE: - �' h✓ j� '�24Z'l%LZ.�I, <br /> r <br /> RECEIVED BY: PHONE: <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE__Lof <br /> PHS 260 (4/98) <br />