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PUBLI�HEALTH SERVICES SAN JOAQUICOUNTY <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 A /� Program ID# fZ`J 3 <br /> Facility Address City cStOU/(q zip 95ao_3 <br /> UST: Dual Wall i gle Wall OVERFILL: Audible Visual_Mechanical <br /> PIPING SYSTEM: Dual wall Single wall'X Suction Pressure Gravity <br /> DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636 (q) requirements? YES_No:>–�— <br /> VIOLATIONS <br /> UST GENERAL REQUIREMENTS TANK # <br /> Permit to 22erate [H&SC 252841 <br /> orma A & B Current & 4 c <br /> Monitoring/Maintenance Records r23CCR 2712 b <br /> Monitoring Records Available r23CCR 2712 <br /> Monitorin Plan 23CCR 2632 d 1 <br /> Response Plan r23CCR 2612 (d) (2) 1 <br /> Unauthorized Releases Re orted [H&SC 252951 <br /> Monitoring Equipment Annus Cert. 23CCR 2630 <br /> Over spill on ainer <br /> Cathodic Protection 23CCR 2635 a 2 A <br /> New USTs Monitored Continuously [23CCR 26301 <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Meters Calibrated r23CCR 2646 (i) l <br /> rnuaj�a Stick in 1 /8 Inches F23rCR 2646 (n) (1) (P) l <br /> Monthly Variations Calculated [23CCR 2646(d) ] <br /> x- ar a ion Proceclure Followed L23CCR 264b e <br /> Inconclusive Procedure Followed [23CCR 2646.1(d) ] <br /> UST Intearity Test Every Two Years 123CCR 2646.1 <br /> Annual SIR Report [23CCR 2646.1(j) ] <br /> ai y Sticic ReacLing c <br /> AUTOMATIC TANK-2AUGTNQ (ATC) <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> Annual ummary Report <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> Annual an n egrl y rest <br /> Tank UaugingProcedure roilowed <br /> Daily Suction i <br /> PipincT Tightness Test 123CCR 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 25298 <br /> Removed, Closed or Temporarly Closed L23CCR 2977U] <br /> REHS INSPECTION DATE/TYPE: <br /> V Of <br /> RECEI BY: PHONE: �� <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE_Lof ;)Li <br />