Laserfiche WebLink
6 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 , A' Facility ID# <br /> Facility Address 44 � X. City <br /> Facility Phone # Faci-lity Contact <br /> Inspection Date: - Inspection Type: ` <br /> UST: Dual Wall Single Wall_ OVERFILL: Audible_ V sual_Mechanical <br /> UST Monitoring ernative !,on- y Nti i3iw/�UST Contents {�� �IfP .'[-�1 ,tea s <br /> PIPING SYSTEM: Dual Wall Single Wall Suction '>< Pressure - Co. av <br /> Does the leak detection system shut off the pump automatically? YES_ NO>� <br /> VIOLATIONS <br /> TANK # <br /> UST GENERAL REQUIREMENTS <br /> Permit to Operate [H&S 25284] <br /> orms A & 6 current c <br /> Monitoring/Maintenance Records L23CCR 2712 (bTT— <br /> FinancialResponsibility [H&S 25292 .2 (a) ] <br /> monitoring Records Available <br /> Monitoring Plan <br /> Response Plan 23CCR 2632 2 <br /> Unauthorized Re eases Re orte H& 5295 <br /> Monitoring Equipment AnnualTest t2.3UUR 2630 <br /> ver still on ainer <br /> Permitted UST Re airs [23CCR 2661 <br /> Permitted Upgrades [23CCR 2660] <br /> cathodic ro ec ion a <br /> MANUAL INVENTORY RECONCILIATION MIR <br /> UST Inte rit Test [23CCR 2643 .1] <br /> Annual MIR Re ort 23CCR 2646 <br /> Meters Calibrated [23CCR 2646 (e) (4) ] <br /> ai Stick reading CR 24-46 (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 /> n e n es ever two ears <br /> Annua SIR Report L23CCR 2646.1 7 <br /> ai y Stick Reading L23CUR 2b4b tC) <br /> AUTOMATIC TANK GAIIGING ATG <br /> Mont hl ATG Results [3CCR 2643 (b) (1) ] <br /> Annua ATG Summary Re ort L23CCR 27120D 2 <br /> MANUAL UST TANK GAUGINGMTG <br /> Tank Gau in Weekl 123CCR 2645 (b) ] <br /> Annua Tan Integrity Test 23CCR 2645 <br /> PIPING MONITORIN <br /> Dail Suction Piping Monitorin [23CCR A .II] <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (d) ] <br /> Gravity i in este ever ears e <br /> Monthly Line Test 23CCR 2643 c 2 <br /> nua ea etector est pp• 1 <br /> LL <br /> SYSTEM STATUS: Major Violations No Violations <br /> COMMENTS: ' ' <br /> REHS: / / / /'CL. 7 r ! C,�C;� RECEIVED' BY: <br /> TITLE• 1� r. K, < PHONE: 4 <br /> FY _ DATE• <br /> Revised Date 1/29/97 23 CCR UST Regs May 5, 1994 <br />