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0 0 <br />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 />Facility Name ^�q <br />=,"Z— Facility ID# <br />Facility Address <br />city Z -C'4'` <br />zip <br />Facility Phone # <br />Facility Contact <br />Inspection Date: <br />Inspection Type: <br />UST: Dual Wall <br />Single wall <br />OVERFILL: Audible <br />Visual Mechanical <br />UST monitoring Alternative <br />UST Contents <br />PIPING SYSTEM: <br />Dual Wall <br />Single Wall Suction <br />Pressure Gravity <br />Does the leak detection system <br />shut off the pump automatically? YES_ NO <br />VIOLATIONS <br />UST GENzRAL-2x0u1RZ—mENTs- <br />Permit to Operate [H&S 252841 <br />G:/' 91ms-' -1 d e r�� — 11 1 /1 1 f% <br />SYSTEM STATUS: Major Violations No Violations <br />RENS : <br />Revised Date 1/29/97 is <br />I ZAIT�r, <br />23 UST Regs May 5, 1994 <br />3 <br />