Laserfiche WebLink
PUBLIC HEALTH SERVICES SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E. Weber Ave. , Third Floor, Stockton, CA 95202 y <br /> (209) 468-3420 L <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility Name /4rr„6 T' ��' �._. Program ID# <br /> Facility Address � c City zip <br /> UST: Dual Wall Single Wall OVERFILL: Audible VisualMechanical <br /> PIPING SYSTEM: Dual wall Single wall Suction Pressure Gravity <br /> DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636 (8) requirements? YES NO <br /> VIOLATIONS <br /> TANK # <br /> UST GENERAL REQUIREMENTS <br /> Permit to Operate [H&SC 252841 <br /> Forms A & B Current H&SC 25284 c <br /> Monitoring/Maintenance Records r23CCR 2712 b <br /> Monitoring Records Available 23CCR 2712 <br /> monitoring Plan 23CCR 2632 (d) (1) ] <br /> Resuonse Plan r23CCR 2632 (d) (2) 1 <br /> Unauthorized Releases Reported [H&SC 252951 <br /> Monitoring Equipment Annual Cert. 23CCR 2630 <br /> ver spill on ainer <br /> Permitted UST Repairs r2l= 29611 <br /> Cathodic Protection 23CCR 2635 a 2 A <br /> New USTs Monitored Continuously [23CCR 2630] <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Meter2 i <br /> Gauging Stink in 1 �8 Inches r2l= 2946 (c) (1) (F) 1_1 <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-variation Procedure k'ollowed L23CCR=6 (e) j <br /> STA=TICAL INVENTORY RECONCILIATION (SIR) <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 Sticr, Reacting c <br /> AUTOMATIC TANK GAUGING (ATG) <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> Annual Summary Report <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> Annual Tankn egri y Test <br /> Tank auging Procedure Followed <br /> Daily Suction Pipincr Monitorincr f23CCR A .II <br /> Piping Tightness Test 23CCR 2643 b c d <br /> Gravity Piping Tested Every 2 Years [23CCR 2643 (e) ] <br /> Monthly Line Test L23CCR 2643Tc-TT27T- <br /> Annual Marc Detector lest <br /> TANK REMOVAL <br /> Permit to Close or Cease Operation H&SC 25298 <br /> Removed, C ose or Temporar y Closed 23CCR 2670 <br /> REHS INSPECTION DATE/TYPE- <br /> RECEIVED BY: PHONE: <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE of <br /> PHS 260 (4198) <br />