Laserfiche WebLink
PUBLI HEALTH SERVICES SAN JOAQUIr COUNTY <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 l Program ID# <br /> Facility Address City zip _ ..._ <br /> UST: Dual Wall_ , Single 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 /> TANK # <br /> UST GENERAL REQUIREMENTS <br /> Permit to O erate [H&SC 252841 <br /> Forms A & B urrent H&SC 252 4 c <br /> Monitorin Maintenance Records 23CCR 2712 (b) 3 <br /> Monitoring Records Available 23CCR 2712 <br /> Monitorin Plan 23CCR 2632 (d) (1) ] <br /> Unauthorized Releases Reported [H&SC 252951 <br /> Monitoring Equipment Annua Cert. 23CCR 2630 <br /> over spill on ainer <br /> Cathodic Protection 23CCR 2635 a 2 A <br /> New USTs Monitored Continuously [23CCR 2630] <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Meters Calibrated r23CCR <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> EX-Variation Procedure Followee) j <br /> STATIS <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 /> Daily Stick Reading c <br /> AUTOMATIC TANK GAUGING (ATG) <br /> Monthly ATG Results 123CCR 2643 (b) (1) ] <br /> Annual summary Report <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> nual -ianK integrity es <br /> aanx uaugingroce ure kolloweQ <br /> PIPING MONITORING <br /> Daily Pii)incr Monitorincf r23CCR ADID.II1 <br /> Piping Tightness Test 123CCR 2643 b c d <br /> Gravit Pi in Tested Ever 2 Years [23CCR2643 (e) ] <br /> Month y Line Test 23CCR 2643 c 2 <br /> TANK REMOVAL <br /> Permit to Close or Cease Operation H&SC 25298 <br /> Removed, Closed or Temporar y Closed 23CCR 2670 <br /> REHS INSPECTION DATE/TYPE: . <br /> RECEIVED BY: PHONE: / <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE of <br /> PHS 231("7) <br />