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%s.. <br />005 <br />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 TANK (UST) PROGRAM INSPECTION REPORT <br />-EEPORT <br />Facility Name e][l.QC81ll.(. GI al eS (,(L Program ID# `J �pl�l�• ` <br />Facility Address -L •� �} ��n%� City( zip <br />UST: Dual Wall Single Wall 0 CFILL• Audible Visual_ Mechanical <br />PIPING SYSTEM: Dual wall Single wall �SuctionPresaure Gravity <br />DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636(8) requirements? YES_NO� <br />VIOLATIONS <br />QST GENERAL REQUIREMENTS <br />Permit to O grate [H&SC 252841 <br />orms A & B urrent [H&SC 25284(b)(c)] <br />Monitorin Main enan Records r23CCR 2712(b)] <br />Monitoring Records Available r23CCR 2712 <br />Monitorinq Plan F23CCR 2632 d 1 <br />Unauthorized Releases Re orted [H&SC 252951 <br />Monitoring Equipment Annua Cert. [23CCR 2630 <br />ver sDiii Container <br />Cathodic Protection 123CCR 2635 a 2 A <br />New USTs Monitored Continuously [23CCR 26301 <br />MANUAL INVENTORY RECONCILIATION (MIR) <br />Meters Calibrated r23CCR 2646(i)l <br />Monthly Variations Calculated [23CCR 2646(d)] <br />Ex -Variation Troceaure FolIowea L;&SUCK ;1646 (e) <br />-RMISTICAL 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 />ai y stick Reading c <br />AUTOMATIC T"K GAUGING (ATGI <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 />,Pamual Tankn egri y iest <br />rank Uaugingroce ure o owe <br />PIPING moNTTnRINr <br />Piving Tightness Test 123CCR 2643 b c d <br />Gravit Pi in Tested Ever 2 Yeara 123CCR2643 (e)] <br />Mont y Line Test 23CCR 2643 c2 <br />TANK REMOVAL <br />Permit to Close or Cease Operation H&SC 25296 <br />Removed, Closedor Temporarly Closed L23CCR 26701 <br />REHS INSPECTI DATE/TYPE: - •—Gi <br />RECEI BY: PHONE: 207'—��2 �J <br />Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE I of <br />PHS 260 (4/98) <br />