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PUBLIC HEALTH SERVICES SAN JOAQVIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E. Weber Ave. , Third Floor, Stockton, CA 95202 <br /> 209/468-3420 <br /> UNDERGROUND TANK PROGRAM,.OF�F.ICIAL INSPECTIOIN REPORT <br /> y <br /> Facility Name �Faty ID# <br /> Facility Addres City yip <br /> Facility Phone # I _ 3Facility Contact <br /> Inspection Date: _ Inspection Type: �.e,/4`�, _ <br /> UST: Dual Wall_ Sing a Wal OVERFILL: Audible_ 'VVisual_Mechanical_ <br /> UST Monitoring Alternative C' ST Contents <br /> PIPING SYSTEM: Dual Wall Single all Suction ressureGravity <br /> Does the leak detection syste shut off the pump automatically? YES_ NO� <br /> VIOLATIONS <br /> UST GENERAL R80IIIREMENTS TANK # <br /> Permit to Operate [H&S 252841 <br /> orma A & b current c <br /> one Orin ain enance Records <br /> Financia Response i ity [H&S 25292.2 (a) ) <br /> monitoring Records AvailalDle <br /> Monitoring Ian <br /> Response Plan L23CCR 2632 <br /> nau orize a easesReported & <br /> Monitoring Equipment Annual Test 23CCR 2630 <br /> ver spin on ainer <br /> Permitted UST Repairs 23CCR 2661 <br /> Permitted Upgrades [23CCR 2660] <br /> catliodic Protection a <br /> MANUAL INVENTORY RECONCILIATION MIR <br /> UST Inte rit Test [23CCR 2643.11 <br /> Annus MIR Re ort 23CCR 2646 <br /> Meters Calibrated [23CCR 2646 (e) (4) ] <br /> Daily tic reading 44 c 1 <br /> Gauging Stick in 1/8 inches [23CCR 2646 (c) (1) (E) ] <br /> STATISTICAL INVENTORY RECONCILIATION 3IR <br /> Excessive Variation Reported 23CCR 2646.1 d <br /> UST integrity ea every two years <br /> Annual SIR Report L23CCR 2646.1 7 <br /> Daily Sticx i <br /> AUTOMATIC TANK GAUGING ATG <br /> Monthly ATG Results [3CCR 2643 (b) (1) ] <br /> Annua ATG Summa Report L23CCR 2712 (b) (2) ] <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gau in Weekl [23CCR 2645 (b) ] <br /> Annua Tan Integrity Test 23CCR 2645 <br /> PIPING MONITORING <br /> 15aily Suction Piping Monitoring 23CCR APP.III <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (d) ] <br /> Gravity i in Tested every 2 years e <br /> Mont y Line Test 23CCR 2643 c 2 <br /> Annual ea a ec or test [23CUR App.IVkI) ta) 1 <br /> SYSTEM STATUS: Major Violations No Violations <br /> COMMENTS: <br /> REHS: RECEIVED BY: <br /> TITLE: , PHONB: DATE: <br /> Revised Date 1/29/97 ��� ` 43©R S s May 5, 1994 <br />