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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 -,,6 Facility ID# -7'7/ <br /> Facility Address .�2� E.p < 5� City G..o� Zip C?3W a <br /> Facility Phone # 3G�- C'" Facility Contact SrzSrc w: -,i7- <br /> Inspection Date: Inspection Type: )wr7 &=_ <br /> UST: Dual Wall(' Single Wall OVERFILL: Audible_ Visual_Mechanical <br /> UST Monitoring Alternative UST Contents <br /> PIPING SYSTEM: '_Dual Wall <br /> _�< rigle Wall Suction Pressure Gravity <br /> Does the leak detection system shut off the pump automatically? YES_ No <br /> VIOLATIONS <br /> UST GENERAL REOIIIREMENTS TANK # n � u <br /> Permit to Operate [H&S 25284] <br /> orms A & B currento <br /> one orin ain enance .ecor s 1 <br /> Financial Responsibility [H&S 25292.2 a <br /> Monitoring Recor s vai a e <br /> one oring an <br /> Response P an LZ3CCR 2632 2 <br /> Unaut orizH395 <br /> MonitorinRimneARuTst 2CR <br /> 2630 <br /> over spill <br /> 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 /> USTInte rit Test [23CCR 2643.1] <br /> Annual MIR Re ort23CCR 2646 <br /> Meters Calibrated [23CCR 2646 (e) (4) 3 <br /> Dailv Stickrea in R 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 /> ub n egri es ever two ears <br /> Annua SIR Report 23CCR 2646.1 ] <br /> Daily bticx Rea ing c <br /> AUTOMATIC TANK GAUGING ATG <br /> Monthl ATG Results [3CCR 2643 (b) (1) ] <br /> Ann ATG Summar Report L23CCR 2712 2 <br /> MANIZAL UST T A I <br /> Tank Gauqinq Weekl [23CCR 2645 (b) ] <br /> AnnualTan Integrity Test 23CCR 2645 <br /> PIPING MONITORING <br /> Daily Suction Pi in Monitorin [23CCR A .II] <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (d) ] <br /> ravit i in este ever ears e <br /> Monthly Line Test 23CCR 2643 c 2 <br /> nua ea a ec or rest pp, <br /> SYSTEM STATUS: Major Violations No Violations <br /> COMMENTS: 5�— /��GG(JG� <br /> REHS: jG r�v.=y� - RECEIVED BY: /L�Cc-zp <br /> TITLE: PHONE: <br /> DATE: <br /> Revised Date 1/29/97 23 CCR UST Regs May 5, 1994 <br />