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E <br />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 TANK PROGRAM OFFICIAL INSPECTION REPORT <br />Facility Name C07 -Lt" Th(,(,.(�[-'� n�ji Facility ID# a,3 /& 69 - <br />Facility Address L K 61 City zip <br />Facility Phone #.10 Facility Cont act tc� <br />Inspection Date: - 7 Inspection Type: <br />UST: Dual Wall_ -Single Wall OVERFILL: Audible_ Visual— <br />Mechanical-UST Monitoring Alternative UST Contents <br />PIPING SYSTEM: Dual Wall Single Wall/<,_Suction Pressure Gravity <br />Does the leak detection systemshut off the pump automatically? YES_ NO <br />VIOLATIONS <br />ixavn � <br />UST GENERAL REQUIREMENTS <br />Permit to Operate [H&S 25284] <br />orms A & B curren c <br />one orin ain enance Records 1 <br />Financia Responsibility [H&S 25292.2(a)] <br />Monitoring Recoras AvailalDle L,�3uux 2/12J <br />Monitoring Pan <br />Response Plan L23UCK 2632 2 <br />Unauthorized Releases Report—ed [H&S 25295] <br />Monitoring Equipment Annual Test L23CCR 2630 <br />Over s 1 on ainer <br />Permitted UST Repairs 23CCR 2661 <br />Permitted Upgrades [23CCR 2660] <br />Cattiodic Protection a <br />MANUAL INVENTORY RECONCILIATION MIR <br />UST Integrity Test [23CCR 2643.1] <br />Annual MIR Report L23CCR 2646 <br />Meters Calibrated [23CCR 2646(e)(4)] <br />Dailv Stick reading CCR 44 C 1 <br />Gauging Stick in 1/8 inches [23CCR 2646(c)(1)(E)] <br />STATISTICAL INVENTORY RECONCILIATION SIR <br />Excessive Variation Reported 23CCR 2646.1(d)] <br />UST Integrity es every two years <br />Annual SIR Report L23CCR 2646.1(3)j <br />ai y Stick Reaaing L23CCR 264b tC)kl)J <br />AUTOMATIC TANK GAUGING ATG <br />Monthl ATG Results [3CCR 2643(b)(1)] <br />An nua ATG Summar Report L23CUR 2712 b 2 <br />MANUAL UST TANK GAUGING MT <br />Tank Gau in Weekl [23CCR 2645(b)] <br />Annua Tan Integrity Test 23CCR 2645 b <br />PIPING MONITORING <br />Daily Suction Piping Monitoring [23CCR App.III <br />Piping Tightness Test (23CCR 2643(b),(c),(d)] <br />Gravity Piping es a every 2 years e <br />Monthly Line Test L23CCR 2643 c 2 <br />7-nnuai LeakDetector test R pp. <br />SYSTEM STATUS: Major Violations No Violations <br />COMMENTS: 5-a' QQa -2�2-' J7— <br />REHS: <br />TITLE: <br />IVED <br />PHONE: DATE: <br />Revised Date 1/29/97 23 CCR UST Regs May 5, 1994 <br />