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1 . ni <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 STORAG TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility Name f�/L�- �/ Program ID#Fac / <br /> USTility DualAWallss 0✓ ST al / � City 4(ti.ti da. Zip <br /> g OVERFILL: Audible Visual Mec nical <br /> PIPING SYSTEM: Dual wall ✓ Single wall Suction Pressure Gravity <br /> DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636 (8) requirements? YES NO <br /> VIOLATIONS <br /> UST GENERAL REQUIREMENTS TANK # <br /> Permit to operate [H&SC 252841 <br /> orms A & B CurrentLH&SC 5 4 c <br /> Monitoring/Maintenance Records F23CCR 2712 b <br /> Monitorin Records Available 23CCR 2712 <br /> Monitorin Plan 23CCR 2632 (d) (1) <br /> Resnonqp P1nn [23CCR 2612 (d) (2) ] <br /> Unauthorized Releases Re orted [H&SC 252951 <br /> Monitoring Equipment Annua Cert. 23CCR 2630 <br /> ver spill on ainer <br /> Cathodic Protection 23CCR 2635 a 2 A <br /> New USTs Monitored Continuously [23CCR 2630] <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> T <br /> Meters Calibrated r23CCR 2646 (i) l <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-Variation Proceaure Followea LZ3CUR 2b4; Fe7T— <br /> STATISTICAL <br /> Inconclusive Procedure Followed [232CR 2646.1(d) ] <br /> UST Integrity Test Ever Two Years 23CCR 2646.1 <br /> Annual SIR Report 1231CR 2141 11j) ] <br /> Daily is ea ing c <br /> AUTO <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 lest <br /> rank uaugingroce ure ollowea <br /> Monitoring R Apy.II1 <br /> Piping Tightness Test r23CCR 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 /> TANK REMOVAL <br /> Permit to Close or Cease Operation H&SC 25298 <br /> Remove , C ose r Temp ar y Closed 23 R 2 7 <br /> REHS INSPECTION DATE/TYPE: 1— <br /> RECEIVED B�te7/15/97 <br /> PHONE: 5,57 - gE.7s - .5� <br /> Revised D 23 CCR UST Regs May 5, 1994 PAGE_�_of <br /> PHS 280 (4/98) <br />