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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 TANK PROGRAM OFFICIAL INSPECTION REPORT <br /> Facility Dame 6;:4 9B`5_74 Lr —1Zvs7-­ Facility ID# <br /> Facility Address :5— 1-0,"1 <br /> City a'�� Zip <br /> Facility Contact —� <br /> Facility Phone # <br /> Inspection Date: q Inspection Type: <br /> UST: Dual Wall_ Sin le Wall pCv�,Pt�a� <br /> Single OVERFILL: Audible_ Visual_MechaniCal <br /> UST Monitoring Alternative UST Contents <br /> PIPING SYSTEM: Dual Wall Single Wall Suction Pressure Gravity <br /> Does the leak detection system shut off the pump automatically? YES_ NO <br /> VIOLATIONS <br /> UST GENERAL RE UIREMENTS TANK # <br /> Permit to Operate [H&S 252841 <br /> orms Curren111111111 1 c <br /> monitor"]n aan enance ecor s <br /> Financia Responsi ity [H&S 25292.2 a <br /> monitoring ecor IS vaz a e <br /> onx oring an17377717 : <br /> Response P an 23CCR 2632 2 <br /> Uncut ize e <br /> DrRe ases Re orte H&S 25295 <br /> Monitoring Equipment Annual Test 23CC1:,1 2630 <br /> ver s i I Con ainercI <br /> Permitted UST Reairs 23CCR 2661 <br /> Permitted Upgrades [23CCR 26601 <br /> catrioalC Pro ec Ion L23CCR 26a <br /> xmw '47-W -�C s <br /> MANUAL INVENTORY RECONCILIATION MIR <br /> UST Inte rit Test [23CCR 2643.11 <br /> Annual MIR Re art 23CCR 2646 <br /> Meters Calibrated [23CCR 2646 (e} {4} ] <br /> Dai tic rea 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.LIST 1 (d) <br /> In! egri es ever wo ears <br /> Annual SIR Report 23CCR 2646.1 3 <br /> Val-L is ea ing c <br /> AUTOMATIC TANK GAUGING ATG <br /> -Monthly ATG Results [3CCR 2643 (b) (1} ] <br /> Annual ATG Summar Re ort 23CCR 2712 M72) <br /> ALT TANK GA <br /> U T MT <br /> Tank Gauging Weekl [23CCR 2645 (b) ] <br /> Annual Tan Integrity Test 23CCR 2645 b <br /> PIPING MONITORING <br /> Dia lr Suction Piping Monitoring [23CCR A II] <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (d) ] <br /> ravitv ina este ever ears 4 e <br /> Monthly Line Test 23CCR 2643 c 2 <br /> nua eak Detec ar est pp 1 <br /> SYSTEM STATUS: Major Violations No Violations <br /> COMMENTS: 5E5 PA -fwd <br /> RENS: 2E�P�&el_ RECEIVED BY: <br /> TITLE; <br /> PHONE: DATE: <br /> Revised Date 1/29/97 23 CCR UST Regs May S, 1994 <br />