Laserfiche WebLink
A0 <br /> PUBLI 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 STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility Name Program ID# <br /> Facility Addresscity '�o zip <br /> UST: Dual Wall Single Wall OVERFILL: Audible -visual Mechanical <br /> PIPING SYSTEM: Dual wall Single wall SuctionPressureGravity_ <br /> DOES THE LEAK DETECTION SYViEM meet 23CCR 2636 (g) requirements? YES NO <br /> VIOLATIONS <br /> TANK # Z' <br /> UST GENERAL REQUIREMENTS <br /> Permit to Operate [H&SC 25284] <br /> Forms A & B urrent H&SC 252 4 I <br /> MonitoringZMaintenance Records [23CCR 2712 (b) l <br /> Financial Resnnnsihility rH&SC 2S292-2 (a) ] <br /> MonitoriM Records Available [23CCR 2712] <br /> Monitoring Plan [23CCR 2632 (d) (1) ] <br /> Rasnonse Plan MCCR 2632 (d) (2) l <br /> Unauthorized Releases ReEorted [H&SC 25295] <br /> Monitoring—Equipment Annual Cert. 23CCR 2630 (d) F— <br /> over slI Container 23= 2jjjQ= <br /> Pt-rmittp.d TTST Rpn;airq r2'ArC:R 26;f;ll <br /> Rer-mitted Ilpgxadas [23Cr_i? �)s;o;nl <br /> Cathodic Protection [23CCR 2635 (a) (2Ajj <br /> New USTs Monitored Continuously [23CCR 2630] <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Tntparit- ry or, <br /> Annual MTP Ponny-t- F'�)IrrP '�0946 (CZ) ] <br /> meters QAjjj2gatCd [23CCE 261k (i) ] <br /> aiicrina Stick in 1/8 lnnhps r23CCR_2&A5_LQLLjLLFj_L_ <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-Varlat-ion Procedure Fo1i6we­d--[2-S= 2646 (e) ] <br /> LIU! <br /> Inconclusive Procedure Follow:d! [23CCR 2646.1 (d) ] <br /> UST Integrity Test Every Two Years [23CCR 2646.1�Sj� j <br /> Annual SIR Report [23CCR 2646.1(j) ] <br /> Daily is Reading L23CCR 2646 (c) (1) ] <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> Annual ATG Summary Report L23­CC!R-2=kb) (2) j <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> Annua.L Tank Integ ity Test LZ3=—Zb-4-5 <br /> an au in Procedure FoII57qeU [23CCR 2b4b (a)-] <br /> 12aily 91ictign Piping Monitoring [2 App.II1 <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (dj ] <br /> Gravity Piping Tested Every 2 Years [23CCR 2643-(e) ] <br /> Monthly Line Test 23CCR 2643 c) (2) ] <br /> 7=Ual Learc Deue=f <br /> TANK REMOVAL <br /> Permit to Close or Cease Operat"lon [H&SC 252981' <br /> Removed, Closed or TemporarIy Closed [23CCR 2970T— <br /> REHS 'e--gz C,14 INSPECTION DATE/TYPE:_ <br /> RECEIVED BY: PHONE: <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE of <br /> PHS 239(9/97) <br />