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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 STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility Name(,L� r/))/�5fre�-t/mai <br /> --"Program ID# �J 1 1 -7 -J pr <br /> Facility Address344fa J5, mai--k, SI S city' " "' <br /> %ffte2'/ Zip S. os <br /> UST: Dual Wa11�Single Wall OVERFILL: Audible Visual—Mechanical <br /> PIPING SYSTEM: Dual wall>C Single wall Suction Pressure-Gravity <br /> DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636 (g) requirements? YES NO_ <br /> VIO ZONSp <br /> TANK # � <br /> UST GENERAL REQUIREMENTS <br /> Permit to O erate [H&SC 252841 <br /> Forms A & B Current H&SC 252 4 c <br /> Monitorin Maintenance Records 23CCR 2712 b <br /> monitoring Records Available 23CCR 2712 <br /> Monitoring Plan 23CCR 2632 (d) (1) ] <br /> Resnonse Plan [23CCR 2632 (d) (2) ] <br /> Unauthorized Releases Re orted [H&SC 252951 <br /> Monitoring Equipment Annua Cert. L23CUR 2630 <br /> Over s i on ainer <br /> Cathodic Protection F23CCR 2635 (a 2 A <br /> New USTs Monitored Continuously [23CCR 2630] <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Meters Calibrated 123CCR i <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-Variation Procedure Foiiowee) 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 /> ai y Stick Reading c <br /> AUT TTC! TANK GAUGING (ATG) <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> Annual NiG Summary Report <br /> MANUAL VST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> Annual ranxn egri y lest <br /> 1anK Gauging Proceaure eoiioweCt <br /> –PTPTNr MONITORING <br /> Daily Suction Piuing monitoring R App.Ill <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 /> Annuai Leax ijetecLOr iest <br /> TANK REMOVAL <br /> Permit to Close or Cease Operation H&SC 25298 <br /> Removed, Close or Temporar y Closed 23CCR 2 70 p <br /> REH 9 ' ` INSPEC�N TE/TYPE: 3-9-1 / rn'47 <br /> e 7 / `/ <br /> RECEIVED BY: �li - , . �' PF30NE: / L�(- y^=21� <br /> Revised Date 7/15/97 3CR UST Regs May 5, 1994 PAGE_j_of <br /> PHS 260 (4/98) <br />