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PUBLI�HEALTH SERVICES SAN JOAQU3N 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 bA4 4.a Program ID# <br /> Facility Addressjy?j?j�Vj�/l� City �gse l7 Zip <br /> UST: Dual Wall Single Wall OVERFILL: Audible_Visual Mechanical <br /> PIPING E LEAK ETEC wall Single wall Suction - <br /> Pressure Gravity <br /> D083 TH8 LAR D8T8CTION SYSTEM meet 23CCR 2636(g) requirements? YES NO <br /> VIOLATIONS <br /> UST GENERAL REQUIREMENTS TANK # <br /> Permit to 0 ;rate [H&SC 252841 <br /> orms & urrent [H&SC 25284c) j <br /> Monitorin Maintenance Records F23CCR 2712 b <br /> Monitoring Records Available 123CCR 2712 <br /> Monitoring Plan 23CCR 2632 d 1 <br /> Reanonse Plan f22CC!R 2632 (d) (2) 1 <br /> Unauthorized Releases Re orted [H&SC 25295] <br /> Monitoring Equipment Annua Cert. L23CCR 2630 <br /> over sD111 containers1 <br /> Cathodic Protection 123CCR 2635 a 2 A <br /> New LISTS Monitored Continuously [23CCR 26301 <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> MTP Report r?-ArrP �.-rar4qlj <br /> Meters Calibrated r23CCR 2646 (i) l <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> x- ar a ion Procedure Followed LZSCCR 2b4b (e <br /> STATIST <br /> Inconclusive Procedure Followed [23CCR 2646.1(d)] <br /> UST Intearitv Test Every Two Years t23CCR 2646.1 <br /> Annual SIR Report [23CCR 2646.1(;) ] <br /> ai F-StiCk Reading c <br /> AUTOMATIC TANK GAUGING (AT01 <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 n n egri y rest <br /> rank uaugingProcedure FoIIoweQ <br /> PIPING momTTnRTNG <br /> Daily Suction Piping n' <br /> Piping Tightness Test 23CCR 2643 b c d <br /> GravityPi in Tested Ever 2 Years 123CCR 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, closedor TeMpOrarly CloseR adnoj <br /> RE ✓moi INSPECTION DATE/TYPE: 7 <br /> RECEIVED BY: PHONE: <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE- <br /> of-PHS 231(Br41( <br />