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PTI`- HEALTH SERVICES SAN JOAQtT,- COUNTY HEALTH DIVISION <br /> 304 E. Weber Ave. , Third Floor, Stockton, CA 95202 <br /> (209) 468-3420 <br /> UNDERGROUND STORAGE TANK <br /> (UST) PROGRAM INSPECTION REPORT <br /> Facility <br /> Program ID# /q'67' <br /> Facility Address �fZo CLt.y—r <br /> UST: Dual WallSingle Wall OVERFILL: Audible Mechanical <br /> PIPING SYSTEM:Dual wall Single wall Suction_Pressure Gravity <br /> DOES THE LEAK DETECTION SYSTEN meet 23CCR 2636 (8) requirements?YES NO <br /> VIOLATIONS <br /> UST GENERAL REQUIREMENTS TANK # <br /> Permit to Operate [H&SC 252841 <br /> Orme A & R rurrent &S 2 4 c <br /> Monitorin Maint nance Records r23CCR 2712 (b) ] <br /> Monitorin Records Available 23CCR 2712 <br /> Monitorin Plan 23CCR 2632 d 1 <br /> Unauthorized Releases Re orted [H&SC 25295] <br /> Monitoring Equipment Annus Cert. 23CCR 2630 <br /> ver spill on ainer [23CCR 2635 (b) ] <br /> Cathodic Protection 23CCR 2635 a 2 A <br /> New LISTS Monitored Continuously [23CCR 26301 <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Annual MIR Report rq';rrP qr4r (q) 1 <br /> Met rs Calibrated F23CCR 4 i <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-Variation Procedure Followed LdJL:UX .4b4bke) J <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 /> Monthly ATG Results [23CCR 2643 (b) (1)] <br /> Annual ummary Report <br /> MANUAL UST TANK GAUGING (NrG) <br /> Tank Gauging Weekly [23CCR 2645(b) ] <br /> Annual n egr> y rest <br /> an augingroce ure b0ll0wea <br /> PIPING MONITORING <br /> Daily Suction Piping <br /> Piping Tightness Test 23CCR 2643 b c d <br /> Gravit Pi in Tested Ever 2 Years [23CCR 2643 (e) ] <br /> Mont y Line Test 23CCR 2643 c 2 <br /> or Cease Operation H&SC 25298 <br /> emove ose or Temporar y Closed CCR 26701 <br /> REHS INSPECTION DATE/TYPE: <br /> RECEIVED BY: PHONE: <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE of <br /> PHS M1"n <br />