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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 TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility Name Tr &Y I�ee Program ID# 27�p_10 <br /> Facility AddressSt5/ ALuNC CityMpO;`_.0-A zip `i'�ZZ� <br /> UST: Dual Wall Single Wall OVERFILL: Audib e Visuaisl_Mechanical <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 /> UST GENERAL REQUIREMENTS TANK # <br /> Permit to O erste [H&SC 252841 <br /> Forms A & B Current LHaSC 25 4 c <br /> Monitoring/Maintenance Records r23CCR 2712 b <br /> Monitoring Records Available23C2 <br /> R 2712 <br /> Monitoring Plan 23CCR 2632 (d) (1) 3 <br /> Responsp Plan F2'AQQR 2642 (d) (2) 1 <br /> Unauthorized Releases Re orted [H&SC 252951 <br /> Monitoring Equipment Annus Cert. L23CCR 2630 <br /> ver spili Container [23CCR 79757511 <br /> Cathodic Protection 23CCR 2635 a 2 A <br /> New USTs Monitored Continuously [23CCR 26301 <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Meters Calibrated F23CCR 2646 (i) l <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-Variation Proceaure Foilowea LTT7=9467e7T_ <br /> STATISTICAL I <br /> Inconclusive Procedure Followed [23CCR 2646.1 (d) ] <br /> UST Integrity Test Ever Two Years 23CCR 2646.1 <br /> Annual SIR Report [23CCR 2646.1 (j) ] <br /> Daily Stick Reacting c <br /> AUTOMATIC TANK GAUGING (A'rr.) <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> Annual ATG Summary Report <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> nusl a'anx Integrity lest <br /> Iank GaugingProcedure kolloweCt <br /> Dai v Suction Piipinq Monitoring R Amp, III <br /> Piping Tightness Test 23CCR 2643 b c d <br /> Gravit Pi in Tested Ever 2 Years [23CCR 2643 (e) ] <br /> Mont y Line Test 23CCR 2643 c 2 <br /> TANK REMOVAL <br /> Permit to Close or Cease Operation H&SC 25296 <br /> Removed, Closed or Temporar y Closed 23CCR 2670J <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 (4196) <br />