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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 />TANK PROGRAM OFFICIAL INSPECTION REPORT <br />Facility Name Facility ID# 2315`k5 <br />Facility Addre s City S�-d.K- zip <br />Facility Phone # - acility Contact ; <br />Inspection Date: 1L Inspection Type: <br />UST: Dual Wall_Single ally_ OVERFILL: Audible_ Visual— <br />Mechanical-UST Monitoring Alternative S2fL UST Contents `.,ye <br />PIPING SYSTEM: Dual Wa11__�Single Wall Suction Pressure Gravity <br />Does the leak detection system shut off the pump automatically? YES_ NO_-:3� <br />VIOLATIONS <br />TANK # <br />UST GENERAL REQUIREMENTS <br />Permit to Operate [H&S 25284] <br />Forms A & B current c <br />-Monitoring/Maintenance .ecor s <br />FiEamcial Responsibility (H&S 25292.2(a)] <br />Monitoring Records AvailaiDle L23CUR 2712J <br />-Monitoring Plan <br />Response Plan 23CCR 2632(d)(2)] <br />Unauthorized Releases Reported H& 2 5 <br />Monitoring Equipment Annual Test 23CCR 2630 <br />Over spill on ainer [23CCR ;ab35(D)J <br />Permitted UST Repairs L23CCR 2661 <br />Permitted Upgrades [23CCR 26601 <br />CathocLic Protection a <br />MANUAL INVENTORY RECONCILIATION MIR <br />UST Inte rit Test [23CCR 2643.11 <br />Annual MIR Re ort' 23CCR 2646 <br />Meters Calibrated [23CCR 2646(e)(4)] <br />Daily tiC reading CR 44 C 1 <br />Gauging Stick in 1/8 inches [23CCR 2646(c)(1)(E)] <br />STATISTICAL INVENTORY RECONCILIATION SIR <br />Excessive Variation Reported 23CCR 2646.1(c0 <br />UST integrity es every two years <br />Annual SIR Report L23CUR 2646.1 7 <br />ai y SticK Reaaing L23CUR a2b4b tC)�I)j <br />AUTOMATIC TANK GAUGING ATG <br />Mont <br />hl ATG Results [3CCR 2643(b)(1)] <br />Annua ATG Summar Report L23CCR 2712(b)(2)] <br />MANUAL UST TANK GAUGING <br />Tank Gau in Weekl [23CCR 1645(b)] <br />Annus Tan Integrity Test 23CCR 2645 b <br />PIPING MONITORING <br />Faily Suction Piping Monitoring 23CCR APP.III <br />Piping Tightness Test [23CCR 2643(b),(c),(d)] <br />Gravity i in es a every years e <br />Monthly Line Test L23CCR 2643 c 2 <br />Annual eaDetector test L23= App.lV(1)(d)J <br />SYSTEM STATUS: Major Violations No Violations <br />COMMENTS: <br />REHS:—{% RECEIVED BY:����`� <br />TITLE: e—W2 Gift \Tjl CC- . PHONE: C ( - II % I DATE: If!:; "I <br />Revised Date 1/29/97 23 CCR UST Regs May 5, 1994 <br />