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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 />TANK PROGRAM OFFICIAL INSPECTION REPORT <br />Facility Name Z&4, ov,cev Facility ID# <br />Facility Address v.cpj Cit Zi <br />Facility Phone # - 2!Facility Contact <br />Inspection Date: /0 '7_7 <br />Inspection Type: p�.r <br />UST: Dual Wall_ Single Wall OVERFILL: Audible_ Visual_Mechanical_ <br />UST Monitoring Alternative UST Contents ,;eA S%G o' <br />PIPING SYSTEM: Dual Wall_ ingle Wall Suction Pressure Gravity <br />Does the leak dep <br />detection system shut off the ump automatically? YET_ NO <br />VIOLATIONS <br />a....n n <br />UST GENERAL REOUIRE4ENTS <br />Permit to Operate [H&S 252841 <br />orms curren c <br />Monitoring/ Maintenance _ecor s <br />Financial Responsibility [H&S 25292.2(a)] <br />Monitoring Recora—s-A—va-iable 123CCR 27121 <br />Monitoring Plan <br />Response Plan 23CCR 2632(d)(2)] <br />Unauthorized Releases Reported & 25 95 <br />Monitoring Equipment Annual Test L23CCR 2630 <br />Over spill on ainer <br />Permitted UST Repairs 23CCR 2661 <br />Permitted Upgrades [23CCR 2660] <br />Uathodic Protection a <br />MANUAL INVENTORY RECONCILIATION MIR <br />UST Integrity Test [23CCR 2643.11 <br />Annual MIR Report 23CCR 2646 <br />Meters Calibrated [23CCR 2646(e)(4)] <br />Dailv Stickrea in R 44 c 1 <br />Gauging Stick in 1/8 inches [23CCR 2646(c)(1)(E)] <br />STATISTICAL INVENTORY RECONCILIATION <br />Excessive Variation Reported 23CCR 2646SIR.1 d <br />Integrity ea every two years <br />Annual SIR Report L23cCR 2646.1(])j <br />Daily 5ticx Reaoing c <br />AUTOMATIC TANK GAUGING ATG <br />Monthl ATResults [3CCR 2643(b)(1)] <br />Annua AG TG Summary Report L23CCR 2712 b 2 <br />MANUAL UST TANK GAUGING MT <br />Tank Gau in Weekl [23CCR 2645(b)] <br />Annua Tan Integrity Test 23CCR 2645 <br />PIPING MONITORING <br />Daily Suction Piping Monitoring [23CCR A .II] <br />Piping Tightness Test [23CCR 2643(b),(c),(d)] <br />Gravity Piping este ever ears e <br />Monthly Line Test 23CCR 2643 c 2 <br />Annual ea a ec or test L23CCR App.IV(1)(d)] <br />SYSTEM STATUS: Major Violations No Violations <br />COMMENTS <br />REHS: <br />RECEIVED BY•I/ <br />\ <br />TITLE: <br />�� /l �>-!' <br />PHONE: 33-3 <br />ZL/ 7L <br />DATE: <br />3 <br />�� <br />Revised <br />Date 1/29/97 <br />23 CCR UST <br />Regs May <br />5, <br />1994 <br />