Laserfiche WebLink
40HEPUBLALTH SERVICES SAN JOAQ 0 LINTY <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 �!\IU) ,S�/ 1' EQ GV/%re— Program ID# 1 [� <br /> Facility Address 67 E. cief'— G/[ Zip �1-6 <br /> UST: Dual Wall >4 ingle Wall OVERFILL: 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 /> ESNOVIOLATIONS <br /> TANK # <br /> VST GENERAL REQUIREMENTS <br /> Permit to O erate [H&SC 25284] <br /> Forms A & B Current tH&SC 25284 c <br /> Monitorin Maintenance Records 123CCR 2712 (b) ] <br /> Monitorin Records Available 23CCR 2712 <br /> Monitorin Plan [23CCR 2632 d) (1) <br /> Unauthorized Releases Reported [H&SC 25295] <br /> Monitoring Equipment =ual Cert. 23CCR 2630 <br /> over spill on ainer L23CUR 2635 (b) ] <br /> Cathodic Protection T23CCR 2635 a 2 A <br /> New USTS Monitored Continuously [23CCR 26301 <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> meters Calibrated2646 (1) 1 <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> EX-Variation Procedure o owe e <br /> STATISTICAL IWVENTO v 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 y Stick Reading c <br /> AUTOMATIC TANK GAUGING (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 ieSt <br /> TanK Gauging Procedure Followed <br /> PIPING MONITORING <br /> Daily i Piping i 2 <br /> Piping Tightness Test 23CCR 2643 b c d <br /> Gravit Pi in Tested Ever 2 Years [23CCR 2643 (e) ] <br /> Mont y Line Test 23CCR 2643 c 2 <br /> e <br /> TANK REMOVAL <br /> Permit to Close or Cease Operation H&SC 25298 <br /> –Ke—moved, Closed or Temporar y Closed 23CCR 2670 <br /> REHS Qi INSPECTION DATE/TYPE: c�-S1CJ��14'l+' <br /> RECEIVED BY: ORPHONE: <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE of <br /> PHS 231("7) <br />