Laserfiche WebLink
r <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 STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility Name` ( v/'�i/ 1.`Yr Program ID#+,(�h� } <br />Facility Address �.30C A- -roY) City 001 Zipg5-. 4r <br />UST: Dual Wall ,:y Single Wa1,,]. OVERFILL: Audible Visual_Me hanical <br />PIPING SYSTEM: Dual wall 'yXs ngle wall Suction Pressure Gravity <br />DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636(8) requirements? YES NO <br />VIOLATIONS <br />ieama tt <br />UST GENERAL REQUIREMENTS <br />Permit to Operate [H&SC 252843 <br />Forms A & B Current H&SC 25284 c <br />Monitoring/maintenance Records 23CCR 2712 b <br />Monitoring Records Available 23CCR 2712 <br />Monitoring Plan 23CCR 2632(d)(1)] <br />Response Plan r23CCR 2632(d)(2)1 <br />Unauthorized Releases Reported [H&SC 252951 <br />Monitoring Equipment Annual Cert. 123CCR 2630 <br />over s5ill conEainer <br />Cathodic Protection 23CCR 2635 a 2 A <br />New USTs Monitored Continuously [23CCR 26301 <br />MANUAL INVENTORY RECONCILIATION (MIR) <br />r 2646(i)] <br />Monthly Variations Calculated [23CCR 2646(d)] <br />Ex -variation Proceaure Followed L23CCR7=67-e-M- <br />STATISTICAL <br />Inconclusive Procedure Followed [23CCR 2646.1(d)] <br />UST Integrity Test Every Two Years 23CCR 2646.1 <br />Annual SIR Report [23CCR 2646.1(j)] <br />Daily Stick Reading c <br />AUTOMATIC TANK GAUGING (ATG) <br />Monthly ATG Results [23CCR 2643(b)(1)] <br />Annual KIG Summary Report <br />MANUAL UST TANK GAUGING (MTG) <br />Tank Gauging Weekly [23CCR 2645(b)] <br />Annual 1anKn egri y lest <br />lanx Gauging Proceaure Pollowea <br />Daily Suction Piping monitoring r2 R ADD.II1 <br />Piping Tightness Test 23CCR 2643 b c d <br />Gravity Piping Tested Every 2 Years [23CCR 2643(e)] <br />Monthly Line Test 123CCR 2643 c 2 <br />Annual r <br />TANK REMOVAL <br />Permit to Close or Cease Operation H&SC 25298 <br />Removed, Closed or Temporar y Closed 23CCR 2670 <br />REHST1k�j %�„ �r*�'` ., NSPECTION DATE/TYPE:�1 Y , ' <br />- a G.ry�j <br />RECEIVED BY: (' � �� PHONE : <br />6- <br />Revised Date 7/1547 23CCR UST Regs May 5, 1994 PAGE_Lof' <br />PHS 260 (4/98) k, <br />