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%Mw 11"w <br /> 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 /> C IINDBRGII�TA, P A0911 <br /> OFFICIAL IN3P8CTION REPORT <br /> Facility Name 8o r� {{�� n Facility ID# <br /> Facility Address City C C Zip n <br /> Facility Phone # Facility Contact <br /> Inspection Date: — Inspection Type: G /hl ` <br /> UST: Dual Wall_ Single fall OVERFILL: Audible_ Viau 1 Mechanical_ <br /> UST Monitoring Alternative UST Contents a <br /> 9groL $2 <br /> PIPING SYSTEM: Dual WallSingle Wall Suction Press6 a Gravity <br /> Does the leak detection cyst shut off the pump automatically? YES_ NO_ <br /> VIOLATIONS <br /> UST GENERAL R80IIIR8M8NT8 TANK # <br /> Permit to Operate [H&S 252841 <br /> orms A & b current c <br /> Monitoring/Maintenance Records <br /> Financial Responsibility [H&S 25292.2 (a)] <br /> Monitoring Recoras Available <br /> monitoring an <br /> Response Plan 23CCR 263 2 <br /> aut orize Releases Reported [H&S <br /> Monitoring Equipment Annual Teat L23CCR 2630 <br /> Over spill on ainer <br /> Permitted UST Repairs 23CCR 2661 <br /> Permitted Upgrades [23CCR 2660] <br /> catnodic Protection a <br /> MANUAL INVENTORY RECONCILIATION MIR <br /> UST Inte rite Test [23CCR 2643.1] <br /> Annual MIR Rort 23CCR 2646 <br /> Meters Calibrated [23CCR 2646 (e) (4) ] <br /> Daily is reading 4 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 d <br /> UST integrity ea every two years <br /> Annus SIR Report 23CCR 2 46.1 7 <br /> Daily i Reacting <br /> AUTOMATIC TANK GAIIGING ATG <br /> Monthl AT <br /> Results 3CCR 2643 (b) (1) ] <br /> Annua ATG Summa Report L23CCR 2712 (b) (2) ] <br /> MANUAL T TANK GAUGING <br /> Tank Gau in Weekl [23CCR 2645 (b) ] <br /> Annus Tan Integrity Test <br /> CR 2645 <br /> PIPING MONITORING <br /> Daily Suction Piping Monitoring 23CCR APP.III <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (d) ] <br /> Gravity i in Tested every 2 years e <br /> Monthly Line Test L23CCR 2643 c 2 <br /> Annual ea a ec or test L23CCR App.IV(I) (d) ] <br /> SYSTEM STATUS: Major Violations No Violations <br /> COMMENTS: L�ol � zy_h2DDritce- tGY-& <br /> R813IS: n=;a2 .� <br /> �LJ/Yif/LGfRECEIVED BY: <br /> TITLE: JIB. T< E S. PHONE: DATE: <br /> Revised Date 1/29/97 23 CCR UST Regs May 5, 1994 <br />