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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 STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility Name Q i t(' � �v C Program ID# o� 3 <br /> Facility Address City �S -D C f(fpyJ Zip <br /> UST: Dual Wall Single Wall OVERFILL: Audible Visual Mechanical <br /> PIPING SYSTEM: Dual wall eSingle wall Suction PressurGravity <br /> DOES THE LEAK DETECTION SYSTEM! meet 23CCR 2636 (g) requirements? YES NO <br /> VIOLATIONS <br /> UST GENERAL REQUIREMENTS TANK # <br /> Permit to 0 erate [H&SC 252841 <br /> Farms A & B Curr6nt LH&SC 25284 c <br /> monitoring/Maintenance Records r23CCR 2712 (b) ] <br /> Financial RespnngibilitV rN&SC 259.99 2 (a) ] <br /> Monitoring Records Available 23CCR 2712 <br /> monitoring Plan 23CCR 2632 (d) (1) ] <br /> Resnonse Plan F23CCR 2632 (d (2) 1 <br /> Unauthorized Releases Reported [H&SC 252951 <br /> Monitoring Equipment Annual Cert. 23CCR 2630 (d)7— <br /> il container [23CCR 2635 (b) j <br /> Permitted UST Rena <br /> PAtMjftPd <br /> Cathodic Protection 23CCR 2635 a 2 A <br /> New USTs Monitored Continuously [23CCR 26301 <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Meters Calibrited [23CCR 2646 (i) l <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-variation Procedure Poiiowed L2_iUCX 2646te) ] <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 /> Monthly ATG Results [23CCR 2643 (b) (1) 1 <br /> Annual Summary Report <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> Annual Tankn egri y Test <br /> Tanic Gaucging Procedure kollowed <br /> pipingMonitoring r2 .II <br /> Piping Tightness Test r23CCR 2643 b c d <br /> Gravity Piping Tested Every 2 Years [23CCR 2643 (e) ] <br /> Monthly Line Test L23CCR 2643 c 2 <br /> TANK REMOVAL <br /> Permit to Close or Cease Operation H&SC 25-2-9—BT— <br /> Removed, <br /> 5298Remove , Closed or Temporary Closed 23CCR 2670 <br /> -� <br /> RENS � GC. NSPEGTION DATE/TYPE: - <br /> RECEIVED BY: -PHONE: j{,{=� <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE <br /> �of <br /> PHS 260 (4196) <br />