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4 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.smcehd.com <br />RQU L1�� EZAGE TA a UST PROf4111�"INSPEGTEE7l'REPORT = . <br />. r <br />6,. O <br />Facility ` U.� ' ]� <br />Name: <br />Facility L <br />Address: /\ +(, L I l/ ) U <br />Inspection / <br />Date: ! <br />_.. t .. <br />Non-Prs�tFiied Piping <br />\f <br />'GO <br />401 <br />CCR 2636(a)(3) <br />Suction piping not properly sloped or incorrectly located check valve (V705) <br />❑ <br />❑ <br />❑ <br />402 <br />CCR 2643(d) <br />Daily monitoring of suction pipe (pre -Jan 1984) not performed (V726) <br />❑ <br />❑ <br />❑ <br />403 <br />CCR 2643(d) <br />Triennial 0.1 gph line test for conventional suction piping not performed (pre -January 1984) (V664) <br />❑ <br />❑ <br />❑ <br />404 <br />CCR 2643(e) <br />Biennial 0.1 gph test for gravity piping not performed (pre -January 1984) (V665) <br />❑ <br />❑ <br />❑ <br />OtherYiolattons. A::. , ". i <br />V <br />R <br />:rsGfl. <br />2010 <br />See below <br />Unlisted Administration/Documentation violation (V736) <br />❑ <br />❑ <br />❑ <br />2030 <br />See below <br />Unlisted Operations/Maintenance violation (V743) <br />❑ <br />❑ <br />❑ <br />2060 <br />See below <br />Unlisted Design/Construction violation (V745) <br />❑ <br />❑ <br />❑ <br />Received by (signs e): <br />Title: <br />Date: <br />ted name): <br />ReceivedIn <br />Pa411 <br />Inspector: _ <br />Inspector phone: <br />�11)� <br />ek. <br />(_ <br />EHD 23-01 FEV 07/28/16 Pa Ci <br />UST INSPECTION REPORT <br />