Laserfiche WebLink
S� <br />C(0) <br />PUBLIC HEALTH SERVICES SAN <br />ENVIRONMENTAL HEALTH <br />304 E. Weber Ave., Third Floor, <br />(209) 468-3420 <br />U <br />JOAQUIN COUNTY <br />DIVISION <br />Stockton, CA 95202 <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility Namei <br />is <br />a' Program ID#P9 <br />monitoring/maintenance Records r23CCR 2712 b <br />Dso 5)& <br />Facility Address <br />Monitoring Plan 23CCR 2632(d)(1)] <br />���iX <br />Unauthorized Releases Reported [H&SC 25295] <br />15 <br />Over spill on ainer <br />City <br />Zip <br />UST: Dual Wall Single <br />Wa;l <br />OVERFILL: <br />Audible r <br />Visual_ Mechanical <br />PIPING SYSTEM: Dual wall <br />V Single wall <br />Suction <br />Pressure Gravity—];? - <br />DOES THE LEAK DETECTION SYSTEM <br />meet 23CCR <br />2636(g) requirements? YES NO <br />Daily is ea ing c <br />AUTOMATIC TANK GAUGING (ATG) <br />Monthly ATG Results [23CCR 2643(b)(1)] <br />Annual ummary Report <br />VIOLATIONS <br />isaavn <br />UST GENERAL REQUIREMENTS <br />Permit to Operate [H&SC 25284] <br />Forms A & B Current LH&SC 25284 c too- <br />monitoring/maintenance Records r23CCR 2712 b <br />Monitoring Records Available 23CCR 2712 <br />Monitoring Plan 23CCR 2632(d)(1)] <br />Response Plan f23CCR 2632(d)(2)1 <br />Unauthorized Releases Reported [H&SC 25295] <br />Monitoring Equipment Annual Cert. L23CERK 2630 <br />Over spill on ainer <br />Cathodic Protection 23CCR 2635 a 2 A <br />New USTs Monitored Continuously [23CCR 26301 <br />f <br />INVENTORY RECONCILIATION (MIR) <br />Meters Calibrated 2 i <br />Gauging Stick in 1)8 Inches r23CCR 2646(c)(1)(R)l <br />Monthly Variations Calculated [23CCR 2646(d)] <br />Ex -variation Procedure FoiloW37723CCR 2646(e)j <br />STATISTICAL INVENTORY RECONCILIATION (SIR) <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 is ea ing c <br />AUTOMATIC TANK GAUGING (ATG) <br />Monthly ATG Results [23CCR 2643(b)(1)] <br />Annual ummary Report <br />MANUAL UST TANK GAUGING (MTG) <br />Tank Gauging Weekly [23CCR 2645(b)] <br />Annual lanxn egri y lest <br />Tank auging Procedure kollowea <br />Daily Suction PipingMonitoring F2 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 L23CCR 2643 c 2 <br />Annuai EeaK Defector <br />TANK REMOVAL <br />Permit to Close or Cease Operation H&SC 25298 <br />Removed, Closed or Temporar y Closed 23CCR 2670 <br />)&HS <br />r WyMPECTION DATE/TYPE : <br />RECEIVED BY <br />Revised Date <br />PHS 260 (4/98) <br />PHONE:, <br />7/15/97 23 CCR UST Regs May 5, 1994 PAGEaof <br />