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rf <br /> PUBLIC HEALTH SERVICES SAN JOAQUIN COUNTY <br /> ENVIRONMENTALDIVISION <br /> 304 E. Weber Ave. , Third Floor, Stockton, CA 95202 <br /> 209/468-3420 <br /> UNDERGROUNDTANK PROGRAM OFFICIAL INSPECTION REPORT <br /> Facility Name /-® i A > L Facility ID# C"i <br /> Facility Address 9�mo Cit L06 iZip � if1 <br /> Facility Phone # 2aSq - !&i Facility Contact <br /> Inspection Date: Inspection Type. t®---* <br /> UST: Dual Wall X Single Wall OVERFILL: Audible_ Visual®Mechanical <br /> ® <br /> UST Monitoring Alternative UST Contents <br /> PIPING SYSTEM: Dual Wall Single Wall_ff Suction Pressure Gravity <br /> Does the leak detection system shut off the pump automatically? YES® NO <br /> VIOLATIONS <br /> TANK # <br /> UST GENERAL REQUIREMENTS <br /> Permit to Operate [H&S 252841 <br /> orms A current c <br /> one orin ain enance Records (23CCR 2TI2-(b) j <br /> Financial Responsibility [H&S 25292.2 a <br /> one oring ecor s vai a e L2-iUCX 2-112J <br /> monitoring Pan <br /> Response Plan L23CCR 2632 2 <br /> Unauthorized Releases Reported H& 252 95] <br /> Monitoring Equipment Annual Test 23CCR 2630 <br /> over spill on ainer <br /> Permitted UST Re aars 23CCR 2661 <br /> Permitted Upgrades [23CCR 26601 <br /> Cathodic ro ec ion a <br /> MANUAL INVENTORY RECONCILIATION JMIRJ <br /> UST Inte rit Test [23CCR 2643.11 <br /> Annual MIR Re ort 123CCR 2646 <br /> Meters Calibrated [23CCR 2646 (e) (4) ] <br /> Dai t—Ick reaElln R 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 2646.1(d) ] <br /> Tnearlty Testevery two years <br /> Annua SIR Report L23CCR 2646.1 ] <br /> ai y sc e ing c <br /> AUTOMATIC T GAUGING ATG <br /> MonthlyATG Results [3CCR 2643 (b) (1)] <br /> Annual ATG Summarx Re ort L23CCR 2712 (b) (2)] <br /> N&MLJ YZST TANK GAUGING <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> Annual Tank Integrity Test 23CCR 2645 b <br /> PIPING MONITgRINrz <br /> Daily Suction Pipina Monitorin [23CCR Lkp12.IIJ <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (d) ] <br /> rave i in es a every 2 yearsL23-CCR--26A-ST-eTT— <br /> Monthly Line Test L23CCR 2643 c 2 <br /> 7irm—uaI LeaRa ec or test L23 R App.lV(1) (d) ] <br /> SYSTEM STATUS: Major Violations No Violations <br /> COMMENTS: <br /> RENS: V RECEIVED BY: <br /> TITLE: Qivr,-xv, . Far— PHONE: " DATE: <br /> Revised Date 1/29/97 23 CCR UST Regs May 5, 994 <br /> i <br />