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0 0 <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 c T Facility ID# 2 3 141?-?- <br /> Facility Address Slv City Tion Zip <br /> Facility Phone # S - Z o Facility Contact T <br /> Inspection Date: (( Inspection Type:_ <br /> UST: Dual Wall_ Single Waller OVERFILL: Audible_ Visual_Mechanical <br /> UST Monitoring Alternative Mlle 4 A^ftua.( UST Contents_ AQ I=t Qn &cis * UL <br /> PIPING SYSTEM: Dual Wail_(Single Wall Suction�_Pres sure Gravity <br /> Does the leak detection system shut off the pump automatically? YES_ NO_ <br /> VIOLATIONS <br /> UST GENERAL REQUIREMENTS TANK # 02 <br /> Permit to Operate [H&S 25284] <br /> orms A & B current c <br /> one orin ain enance Records L23i <br /> Financial Responsibility L11&b 25292.2 a <br /> monitoring ecor s Available [23CQx 2112J <br /> one oring Plan <br /> Response Plan L23CCR 2632 2 <br /> unauthorized Releases Report—ed-J-H&S 25295 <br /> Monitoring Equipment Annual Test 23CCR 2630 <br /> ver spill on ainer <br /> Permitted UST Repairs 23CCR 2661 <br /> Permitted Upgrades [23CCR 2660] <br /> Cathodic ro ec ion a <br /> MANUAL INVENTORY RECONCILIATION MIR <br /> • UST Integrity Test [23CCR 2643.1] <br /> Annual MIR Re ort 23CCR 2646 •i <br /> Meters Calibrated [23CCR 2646 (e) (4) ] <br /> Daily tic res in R 44 c 1 <br /> Gau in Stick in 1/8 inches [23CCR 2646 (c) (1) (E)] <br /> STATISTICAL INVENTORY RECONCILIATION SIR <br /> Excessive Variation Reported 23CCR 2646.1 d <br /> USi Integrity ea every two years <br /> Annual SIR Report L23CCR 2646.1 <br /> ai y Scicr, xeXU'3.ng C-771) 1 <br /> AUTOMATIC TANK GAUGING ATG <br /> Monthl ATG Results [3CCR 2643 (b) (1) ] <br /> Annus ATG Summar Re ort 23CCR 2712 2 <br /> MANUAL T TANK GAUGING (MTG) <br /> Tank Gauqinq Weekl [23CCR 2645 (b) ] <br /> Annus Tan Integrity Test 23 <br /> CCR 2645 <br /> PIPING MONITORING <br /> Dail Suction Pi in Monitorin [23CCR <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (d) ] <br /> Gravity Ming es a ever ears e <br /> Monthly Line Teat 23CCR 2643 c 2 <br /> Annual ea a ec or tespp.lVTfTTaTT— <br /> SYSTEM STATUS: Major Violations No Violations <br /> • COMMENTS:.91k <br /> REaHS: <br /> � RECEIVED <br /> TITLE•y E�{S PHO <br /> a D"A�TE^^. ti <br /> Revised Date 1/29/97 23 CCR UST Regs May 5, 1994 <br />