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0 <br />PUBLIfHEALTH 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 LZAthrki�&L Program ID# 3 /k.2 0 <br />Facility Address 11?!�6 pi-ceell, City Zip zip 9b--'R'on� <br />UST: Dual Wall X*, Single Wall OVERFILL: Audible &V- Visual Mechanical. <br />PIPING SYSTEM: Dual wall )mC Single wall 5< Suction X Pressure Gravity <br />DOES THE LEAK DETECTION SYSTEM meet 23C- 2636(8) requirements? YES NO <br />VIOLATIONS <br />UST GENERAL REQUIREMENTS <br />JJURE� �090- �-M <br />Monitoring Records Available [23CCR 2712]____ <br />•itorinq• Plan [23CCR 2632(d)( <br />Unauthorized Releases Reported [H&SC 252951 <br />MonitorTng -Equipment Annual Cert. L23CCR 2630(d)] <br />i' <br />MOO BM <br />T�FXWAVA-11-31 <br />PArmi ttprj Tipgararij <br />q r2l(IrR 9.f;0;01 <br />Cathodic Protection [23CCR 2635(a)(2)(A)l <br />i�- <br />New USTs Monitored continuously [23CCR 26301 <br />MANUAL INVENTORY RECONCILIATION (MIR) <br />left -NEW -MR. M.M <br />BMW <br />Monthly Variations Calculated [23CCR 2646(d)] <br />Ex-Varlation Procedure FoilowecL L23CUR 2b4b ke) <br />STATISTICAL INVENTORY RECONCILIATION (SIR) <br />Inconclusive Procedure Followed [23CCR 2646.1(d)] <br />UST Integrity Test Every Two Years [23CCR 2646.1(q)] <br />Annual SIR Report (23CCR 2646.1(j)] <br />'9t i ck Reading - - L 2 3 CCR 2 6 4 6 <br />Annual ATG Summary Report L23CCR 77127b)k2)j <br />MANUAL UST TANK GAUGING (MTG) <br />Tank Gauging Weekly [23CCR 2645(b)] <br />--Annual lank Integrity lest <br />F Men V ON <br />WORM- zi I <br />Gravity Piping Tested Every 2 Years [23CCR-2643(e)] <br />Monthly Line Test L23CCR 2643(c)(2)] <br />TANK REMOVAL <br />perat-i-on [H&:SC 252981 <br />Removed, Closed or Temporarly Closed L23CCR 2670] <br />E <br />REHS �,-4 <br />INSPECTION DATE/TYPE: <br />RECEIVED BY: PHONE: <br />Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE / of <br />PHS 291 (9/97) <br />1". <br />