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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 /> UNDER UND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility Name 7%C*— Program ID# Z'S -0 <br /> Facility Address- city zip <br /> UST: Dual WaMS�ingle�Waj)e�1�0�VZRFI`LL: A�udib-le visual Me <br /> PIPING SYSTEM: Dual wall Single wall Suction—Press �cnical <br /> ?r <br /> Pressure Gravity <br /> DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636 (8) requirements? YES NO <br /> TANK # VIOLATIONS <br /> UST GENERAL REQUIREMENTS <br /> Permit to Operate [H&SC 25284] f <br /> Forms A '& B Current <br /> Monitorina/Main tenance Records [23CCR 2712 (b) ] <br /> Finannia pQn.9ji2jijtv m&sC! 2r,292-2 (a) l <br /> Monitoring Records Available [23CCR 27121 <br /> Monitoring Plan [23CCR 2632 d) (1) ] .................. <br /> HgapQng2 Plan r2lrCR 2622 (d) (2) ] <br /> Unauthorized Releases Reported [H&SC 25295] <br /> Monitoring-Equipment "Annual Cert. [23CCR 2630 (dTT— <br /> on ainer <br /> 12a Mi-j--t-Aci TTqrr Renairq r21rrR_2fifjj] <br /> Po=-rmi ti-a- grades [23CCR qggni <br /> Cathodic Protection r23CCR 2635 (a) (2) (A) j <br /> New USTs Monitored Continuously [23CCR 2630] <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> gr.ity Test 121 -- -R 264111 <br /> part 01 2646 (gll <br /> Metarg Calibratgd r23CCR 2fi46(7) 1 <br /> n=il%T Qi-inlc Pa=rjincT ria(,tv '14AA (t�l 11 ) 1 <br /> ("aucring At-ick in jZ8 InchAs r21CCR 2646 (c) (1) (P.11 <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-variation Proceffu-re Followea L23CCR 2646 (eyT <br /> RISE k[M;;;aMjQX (SIR) <br /> Inconclusive Procedure Followed [23CCR 2646.1(d) ] <br /> UST Integrity Test- Every Two Years r23CCR 2646.1 <br /> Annual SIR Report [23CCR 2646.1(j) ] <br /> Daily is Reading [23CCR 2646 (C) (1) 1---- <br /> IN2 (&Tra) <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> =muaI ATG summary ReporE L23=R 2712 (F)) (2) ] <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly—[23CCR 2645 (b) ] <br /> Annuai Tank Lntegr1ty--T-efff—E23L:cK zb45-jnTj <br /> rXnX Gauging Procecture-F-5TI—owe <br /> d -Lz3LCR-2-645(33 ] <br /> dily aLigl;ign E!ipina Monitogina r23C!C& 11] <br /> Pi in Ti_qhtness Test [23CCR 2,643 (b) . (c) , (d) ] P7— <br /> Gravity Piping Tested Every 2 Years [23CCR- 2643 (e) ] <br /> Monthly-Line Test [23CCR 26-43[c) (2) ] <br /> lknnuai rjeaX DerigZ=r Test r23CCH 2b3U(CL) i <br /> TANK REMOVAL <br /> Permit to Close or Cease Operation [H&SC 252981 <br /> Removed, Oe r T <br /> /P yTorarly C1osed--[-2T'-qCR 26701'' <br /> REHS INSPECTION DATE/'TYPE: �- 77tM <br /> RECEIVED BY; <br /> Revised Date 7/y <br /> 1 /97 23 CCR UST Regs May 5, 1994 PAGE—L-Q-L� <br /> PHS 260 (4/98) <br />