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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 /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility Name ple-lf - ze,C- Program ID# <br /> C <br /> Facility Address �Z7 15 . A ip' ,,,,,may( City 3 <br /> UST: Dual Wall Single Wall OVERPILL: Audible Visual Mechanical <br /> PIPING SYSTEM: Dual wall Single wall Suction—Pressure Gravity <br /> DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636 (g) requirements? YES NO <br /> VIOLATIONS <br /> UST GENERAL RE IIIREMENTS TANK # <br /> Permit to O erste [H&SC 252841 <br /> orms A & B urrentLH&SC 25284 (b) (c)] <br /> _FFo—nitorIiig/maintenance Records F23CCR 2712 <br /> Monitoring Records Available 23CCR 2712 <br /> Monitorinq Plan 123CCR 2632 d 1 <br /> Response Plan r2'ACC'R 9619 (d) (9) ] <br /> Unauthorized Releases Re orted [H&SC 252951 <br /> Monitoring Equipment Annua Cert. L23CCR 2630 <br /> Over spill on ainer L23CCR 2635(b) ] <br /> Pp=it,t,pfi UST Repairs F�1.3= 29r11 <br /> Cathodic Protection 123CCR 2635 a 2 A <br /> New USTs Monitored Continuously [23CCR 26301 <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Meters Calibrated r23CCR 2646 (i) l <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-Variation Proceaure Followee) j <br /> STATISTICAL INVENTORY RECONCILIATION (SIR) <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 /> ai yis ea ing c <br /> AUTOMATX,C--TANK GAUGING (ATO) <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> AnnuaI AxU bummary xeport <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> Annual anx Integrity rest <br /> I'anx Gaugingroce ure FoIlowea <br /> OTDTMa <br /> Daily Suction Pipincr Monitoring <br /> Piping Tightness Test 123CCR 2643 b c d <br /> Gravit Pi in Tested Eve 2 Years [23CCR 2643 (e) ] <br /> Mont y Line Test 23CCR 2643 c 2 <br /> TANK REMOVAL <br /> Permit to Close or Cease Operation H&SC 25298 <br /> Removed, Closed or TemporaY y Closed [23CCR 26701 <br /> REHS awe.. <br /> RECEIVED BY: PHONE: 2 <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE�of--� <br /> PHS 260 (488) <br />