Laserfiche WebLink
PUBLI%EALTH SERVICES SAN JOAQU1,9COUNTY <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 Program ID# <br />IF <br />Facility Address it�'L_4MAA: - zip <br />C <br />UST: Dual Wall:Altingl-e(OVERALLN—Audible Visual Me(;hanical <br />PIPING SYSTEM: Dual wall Single wall Suction Pressu'�e_,,/Gravity - <br />DOES THE LEAK DETECTION _SN_TEM meet 23CCR 2636(g) requirements? YES NO::�Z <br />VIOLAT`IONS <br />Ixxi,A ;ff <br />UST GENERAL --REQUIREMENTS <br />Permit to Operate [H&SC 252843 <br />elm M.W. M IM161*1 ,a <br />Monitoring Records Available [23CCR 27121 <br />MonitoringPlan [23CCR 2632(d)(1)] <br />FEZ <br />Unauthorized Releases Reported [H&SC 25295] <br />Monitoring Equi—pment Annual Cert. [23CCR 2630(d)1_11W���nWJFAM <br />Cathodic Protection [23CCR 2635(a)(2)(A)l <br />New USTs Monitored Continuously [23CCR 2630] <br />MANUAL INVENTORY RECONCILIATION (MIR) <br />WME. MERFMCIEW M., <br />_Mgjq._x_s Calibrated r23CCR <br />war--NEKTAIL-4 M.MWEII.I.M.-MIS ".1-Wilmm <br />Em%wipjapipev"s <br />Monthly Variations Calculated [23CCR 2646(d)] <br />Ex_"TratjAt�fbfj 17rocedur�e__Foliowect L23CCR <br />Inconclusive Proc dure Followed[23CCR 2646.1(d)TJ� <br />-_ - <br />Annual SIR Report [23CCR 2646.1(j)] <br />Daily Stick Reading-L23CCR 2646 (c)(1)j <br />Monthly ATG Results [23CCR 2643(b)(1)] <br />Annual ATG summary Report L23CCR 2712(b)(2)j <br />MANUAL UST TANK GAUGING (MTG) <br />Tank Gauging Weekly [23CCR 2645(b)] <br />Annua.L Tanx integrity lest L;&-3UUx ;4b45 (D) I <br />Daily Suction Piping Monitori <br />Piping Tightness Test [23CCR 2643(b),(c),(d)] <br />=9=1 ��­N V4FA=9PA91W_4V'NWA'-MtCzmw <br />Monthly Line Test [23CCR 2643(c)(2)] I�AM_ANXWA <br />TANK REMOVAL <br />y Closed [23CCR 2670 <br />REHS INSPECTION DATE /TYPE:/ <br />RECEIVED BYX-> PHONM <br />Revised Date /+15/7 23 CCR UST Regs\May 5, 1994 PAGE—Lof I" <br />PHS 231 (9/97) <br />