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PUBLI�-`HEALTH SERVICES SAN TOAQUIN 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 GV <br /> Program ID# <br /> Facility Address /3915- s. c.SogGo <br /> UST: Dual Wall Sin le Wall LLCity c5�p t�,�zip <br /> PIPING SYSTEM: Dual wall Single wall . SucctionPressure udibleVisual MecGravity <br /> DOES THE LEAK DETECTION SYSTEM meet 23CCR 22636 (8) requirements? YES NO <br /> VIOLATIONS <br /> MTG8N8RAL REQUIREMENTS TANK # <br /> Permit to O erate [H&SC 25284] <br /> Forms A & B Current H& <br /> 2b28 c <br /> Monitorin Maintenance Records CR 2712 (b) <br /> Mbnitorinq Records Available 23C2R 2712 <br /> Monitorin Plan [23CCR 2632 (d) 1 <br /> Unauthorized Releases Re or ted [H&SC 25295] <br /> Monitoring Equipment Annua Cert. 23CCR 2630 <br /> ver s i on ainer <br /> Cathodic Protection r23CCR 2635 (a 2 A <br /> New USTs Monitored Continuously [23CCR 26301 <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> .11 2941 1 <br /> Meters Calibrated 123CCR 2646 (i) ] <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-Variation Procecture Followed L23CCR 264ETe-7T— <br /> STATISTICAL <br /> Inconclusive Procedure Followed [232CR 2646.1 (d) ] <br /> UST Integrity Test Ever Two Years 23CCR 2646. 1 <br /> Annual SIR Report 123111 2646.1 (j) ] <br /> Daily is ea ing c <br /> -AUTOMATIC TANK AUGING (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 an n egri y lest <br /> Tanx Uaugingroce ure kollowea <br /> Daily Suction Piping Monitoring R <br /> Piping Tightness Test 23CCR 2643 b c d <br /> Gravit Pi in Tested Ever 2 Years [23CCR 2643 (e) ] <br /> Monthly Line Test 23CCR 2643 c 2 <br /> Annual e <br /> RHMO <br /> ose or Cease Operation H&SC 25298 <br /> Remove- , Closea Closeor Temporar y Closed [23CCR 2670 <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 231 W97) <br />