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REMOVAL_1998
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231345
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REMOVAL_1998
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Entry Properties
Last modified
9/1/2021 2:10:38 PM
Creation date
10/11/2018 2:12:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
REMOVAL
FileName_PostFix
1998
RECORD_ID
PR0231345
PE
2381
FACILITY_ID
FA0003713
FACILITY_NAME
CHEVRON #95775 MCCOMBS* (INACT)
STREET_NUMBER
301
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04514002
CURRENT_STATUS
02
SITE_LOCATION
301 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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PUBLIu 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 Program ID# <br />Facility Address City zip <br />UST: Dual Wall Single Wall OVERFILL: Audible Visual_ Mechanical <br />PIPING SYSTEM: Dual wall Single wall Suction Pressure Gravity <br />DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636(8) requirements? YES NO <br />VIOLATIONS <br />UST GENERAL REQUIREMENTS <br />Permit to Operate [H&SC 252841 <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 />Resnonse Plan r23CCR 2632(d)(2)1 <br />Unauthorized Releases Reported [H&SC 25295] <br />Monitoring Equipment Annual Cert. 23CCR 2630 <br />Over spill on ainer <br />Pt-rmitteri UST Repairs r2;C,(,]R 2f;611 <br />Cathodic Protection 23CCR 2635 a 2 A <br />New USTs Monitored Continuously [23CCR 26301 <br />MANUAL INVENTORY RECONCILIATION (MIR) <br />UST Tntparity Test 23 <br />Meters 2 R 264 6(1)1 <br />Gauging stink in 1�8 Inches r23CCR 2646(c)(1)(F)l <br />Monthly Variations Calculated [23CCR 2646(d)] <br />Ex -Variation roce ure o iowect L23CCR 2646(e)j <br />STATISTICAL INVENTORY RECONCILIATION (SIR) <br />Inconclusive Procedure Followed [23CCR 2646.1(d)] <br />UST IntecTrity Test Every Two Years 23CCR 2646.1 <br />Annual SIR Report [23CCR 2646.1(j)] <br />Daily Sticx Reacting c <br />_A=OMATT-C TANK GAUGING (ATG) <br />Monthly ATG Results [23CCR 2643(b)(1)] <br />Annual Summary Report <br />MANUAL UST TANK GAUGING (MTG) <br />Tank Gauging Weekly [23CCR 2645(b)] <br />Annual rankn egri y lest <br />an auging roce ure o owe <br />Daily Suction Piping monitoring r2 CR Aipp.III <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 7cTT2—TT-- <br />Annual EeaR <br />TANK REMOVAL <br />Permit to Close or Cease Operation H&SC 25298 <br />Removed, Closed or Temporar y C ose 23CCR 2670 <br />REHS <br />RECEIVED BY: <br />INSPECTION DATE/TYPE: <br />PHONE: <br />Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE of <br />PHS 231 (9/97) <br />
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