Laserfiche WebLink
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 TANK PROGRAM OFFICIAL INSPECTION REPORT <br /> Facility Name 6:T A i G Facility ID# <br /> Facility Address k ` rv�c,_ks+ L��c2d City Ts zip <br /> Facility Phone # Facility Contact_ _ l� <br /> Inspection Date: 4{41(�/eL, Inspection Type: <br /> UST: Dual Wall_ in le Wall OVERFILL: Audible Visual_Mechanical_ <br /> UST Monitoring Alternative UST Contents 'N\VF <br /> PIPING SYSTEM: Dual Wall Single Wall Suction Pressure_XGravity <br /> Does the leak detection system shut off the pump automatically? YES NO_ <br /> VIOLATIONS <br /> UST GENERAL REQUIREMENTS TANK # <br /> Permit to Operate [H&S 252841 <br /> Forms A & B current c <br /> monitoring/Maintenance Records L23CCR 2712 (b) j <br /> Financial Responsibility [H&S 25292.2 (a) ] +/ <br /> Monitoring Records Available L23CUR 2 /12J <br /> Monitoring Plan �( <br /> Response Plan L23CCR 2632 (d) (2) ] .0 P DE <br /> Unauthorized Releases Reported H&S 25295 <br /> Monitoring Equipment Annual Test 23CCR 2630 <br /> over spill on ainer <br /> Permitted UST Repairs [23CCR 2661 <br /> Permitted Upgrades [23CCR 26601 <br /> Cathodic ro ec i.on a <br /> MANUAL INVENTORY RECONCILIATION MIR <br /> UST Integrity Test [23CCR 2643.11 <br /> Annual MIR Report 23CCR 2646 <br /> Meters Calibrated [23CCR 2646 (e) (4) ] <br /> Daily Stick reading CCR 44 c 1 <br /> Gauging Stick in 1/8 inches [23CCR 2646 (c) (1) (E) ] <br /> STATISTICAL INVENTORY RECONCILIATION SIR <br /> Excessive Variation Reported L23CCR 2646.1 (d) <br /> USE Integrity es every two years <br /> 2b4b.17g`TT— <br /> Annual SIR Report L23CCR 2646.1 <br /> Daily stick Reading c <br /> AUTOMATIC TANK GAUGING ATG <br /> Monthly ATG Results [3CCR 2643 (b) (1) ] <br /> Annual ATG Summary Re ort 23CCR 2712 b 2 <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekl [23CCR 2645 (b) ] <br /> Annual Tank Integrity Test L23CCR 2645 (b) ] <br /> PIPING MONITORING <br /> Daily Suction Piping Monitoring [23CCR App.III <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (d) ] <br /> Gravity Piping este every 2 years e <br /> Monthly Line Test L23CCR 2643 c 2 <br /> Annuai LeakDetector test L23CCR App.lV(1) (d) j <br /> SYSTEM STATUS:: Major Violations No Violations <br /> COMMENTS• �\ IJ4f c� QA <br /> REHS: �- CS" RECEIVED BY: <br /> TITLE: PHONE: DATE: <br /> Revised Date 1/29/97 23 CCR UST Regs May 5, 1994 <br />