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• 0 <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 /> UNDERGROUND TANK PROGRAM OFFICIAL INSPECTION REPORT <br /> Facility Name 11 CA Facility ID# <br /> Facility Address Z2�5 cti �v GC&V City !^— Zip <br /> Facility Phone # Facility Contact <br /> Inspection Date: 1'c71&14,7 Inspection Type: <br /> UST: Dual Wall_ Single all_ OVERFILL: Audible_ Visual- <br /> Mechanical-UST Monitoring Alternative UST Contents <br /> PIPING SYSTEM: Dual Wall Single Wall Suction Pressure Gravity <br /> Does the leak detection systet shut off the pump automatically? YES_ NO_ <br /> VIOLATIONS <br /> TANK # <br /> VST GENERAL REQUIREMENTS <br /> Permit to Operate [H&S 252841 <br /> orms A & B curren c <br /> Monitoring/Maintenance _ecor s <br /> Financial Responsibility JH&S 25292.2 (a) ] <br /> monitoring Records Availanle <br /> monitoring Plan <br /> Response Plan 23CCR 2632 2 <br /> Unauthorizea Re eases Re orte H& 295 <br /> Monitoring Equipment Annua Test L23CUR 2630 <br /> over spill on ainer <br /> Permitted UST Repairs 23CCR 2661 <br /> Permitted Upgrades [23CCR 2660] <br /> cattodic Protection a <br /> MANUAL INVENTORY RECONCILIATION MIR <br /> UST Integrity Test [23CCR 2643.11 <br /> Annual MIR Report 23CCR 2646 <br /> Meters Calibrated [23CCR 2646 (e) (4) ] <br /> Dailv Stickrea in 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(d) <br /> Integrity es every two ears <br /> Annua SIR Report 23CCR 2646.1 ] <br /> ai y stick Reaaing c <br /> AUTOMATIC TANK GAUGING ATG <br /> MonthlATG Results [3 CCR 2643 (b) (1) ] <br /> Annua ATG Summar Report L23uuR 2712 b 2 <br /> MANUAL UST TANK GAUGING <br /> Tank Gau in Weekl 123CCR 2645 (b) ] <br /> Annua Tan Integrity Test 23CCR 2645 <br /> PIPING MONITORING <br /> Daily Suction Piping Monitoring [23CCR App.III <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (d) ] <br /> ravit i in este ever ears e <br /> Monthly Line Test 23CCR 2643 c 2 <br /> Annual ea etector test L23CCR App.lV(1) (d) J <br /> SYSTEM STATUS: /Major Violations No Violations <br /> COMMENTS: :5A�_7e-1,5%af%.- <br /> REHS: RECEIVED BY: <br /> TITLE: PHONE: DATE: <br /> Revised Date 1/29/97 23 CCR UST Regs May 5, 1994 <br />