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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 TANK PROGRAM OFFICIAL INSPECTION REPORT <br /> Facility Name c¢ T Y —SaWC, FacilityM#Sf- 21-3 <br /> Facility AddressLI& _ City S zip <br /> Facility Phone # Facility Contact /C <br /> Inspection Date: 6. _1/ =4 1Inspection Type:- 9�21—vn <br /> UST: Dual Wall_ ingle all ✓OVERFILL: Audible_ Visual(_Mechanical— <br /> UST Monitoring Alternative UST Contents C�,p�Q//'�L„ <br /> PIPING SYSTEM: Dual Wall/ Single Wall_Suction�Pressure Gravity <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 252841 <br /> orms A & b current c <br /> Monitoring/Maintenance Records <br /> Financial Responsibility [H&S 25292.2 (a) ) <br /> monitoring Records Available L23CCR 2112J <br /> onI oring an <br /> Response P an 23CCR 2632 2 <br /> Unauthorized Re eases Re orte H&S 25295 <br /> Monitoring Equipment Annua Test 23CCR 2630 <br /> over spill on ainer <br /> Permitted UST Repairs L23CCR 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 Report 23CCR 2646 <br /> Meters Calibrated [23CCR 2646 (e) (4) ] <br /> Daily 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 /> a.6TG7,TTg`TT-- <br /> Annual SIR Report t23CCR 2646.1 <br /> aI yis ea Ing c <br /> AUTOMATIC TANK GAUGING ATG <br /> Moth <br /> l ATG Results [3CCR 2643 (b) (1) ] <br /> I= a ATG Summary Report 23CCR 2712 (b) (2) ] <br /> MANUAL UST TANK GAUGING MTG <br /> Tank Gau in Weekl 123CCR 2645 (b) ] <br /> Annua Tan Integrity Test 23CCR 2645 b <br /> PIPING MONITORING <br /> Daily Suction Piping Monitoring 123CCR A .II] <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (d) ] <br /> Gravity I In este every 2 vears e <br /> Monthly Line Test L23CUR 2643 c 2 <br /> =nual -Leak Detector test L23CCR App.IV(1) (d) j <br /> SYSTEM STATUS: Major Violations No Violations <br /> COMMENTS• <br /> RENS: �, �.t •!�-� RECEIVED BY//: <br /> TITLE � PHONE: `C' — 7 G DATE: �'� <br /> Revised Date 1/29/97 23 CCR UST Regs May 5, 1994 <br />