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PUSLIL�HEALTH SERVICES SAN JOAQUIIf 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 RIG�ah j 0. j3 ` " Program ID# .. /700 J�e 3 g <br /> Facility Address '313 0D City Zip o�6 <br /> UST: Dual Wall Single Wall RFILL: Audible-Visual-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 /> rft)K Ly, ( cQ/ TANK # VIOLATIONS <br /> . UST GENERAL REQUIREMENTS <br /> Permit to B erste [H&SC 252841 <br /> orma & urren & 4 c <br /> Monitoring/Maintenance Records r23CCR 2712 b <br /> Monitoring Records Available 23CCR 2712 <br /> Monitoring Plan 23CCR 2632 d 1 <br /> Response Plan r23CCR 2632 (d) (2) 1 <br /> Unauthorized Releases Re orted [H&SC 252951 <br /> Monitoring Equipment Annus Cert. L23CCR 2630 <br /> ver spill on ainer LZJCCR 2635 (b) ] <br /> Cathodic Protection 23CCR 2635 a 2 A <br /> New USTs Monitored Continuously [23CCR 2630] <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> x- ar a ion Procedure Followed J;&3UUR 2b4b (e) j <br /> STATISTICAL 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 /> Daily Stick Reading c <br /> A13T TIC TANK GAUGING (ATC) <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> Annual Summary epor <br /> MANUAL QST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> Annual n egri y iesr <br /> Tanx uaugingro ure o owe <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 25298 <br /> Removed, Closedor Temporar y Closed [23CCR <br /> REHS INSPECTION DATE/TYPE: <br /> RECEIVED BY: PHONE: <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE_L_of <br /> PHS 231(eel <br />