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PUB <br /> LI 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_ 1076 Program ID# <br /> . -S - <br /> Facility Address Y6 Zzu 1-3 CityZip <br /> UST: Dual Wall Address <br /> OVERFILL: Audible—vi ica <br /> al— ec�g-n �,�&,� <br /> PIPING SYSTEM: Dual wall :��Single wall Suction Pressure oe�Gravi�ey <br /> DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636 (g) requirements? YES P-1"NO <br /> VIOLATIONS <br /> TANK # <br /> UST GENERAL REQUIREMENTS <br /> Permit to 02erate [H&SC 25284] <br /> Forms A & B Current�H&S�C25284c) j <br /> Monitorinq/Maintenance Records [23CCR 2712 (b) ] <br /> Financial RpRnnnRihilitv rH&SC 2S292,,' <br /> Monitoring Records Available [23CCR 2712J <br /> Monitoring Plan [23CCR 2632 (d) (1) ] <br /> [23CCg 2632 (d) (2) ] <br /> Unauthorized Releases Reported [H&SC 25295] <br /> Monitoring Equipment Annual Cert. [23CCR 2630 (d) ] <br /> Over spill Container L29CCR <br /> Pp-rmitted TTST RpnAirs r2lrCR 29911 <br /> RerMit-tjza TTnrT-r=rjzS [23CC]R 269nl <br /> Cathodic Protection [23CCR 2635 (a) (2) (A) j <br /> New USTs Monitored Continuously [23CCR 2630] <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> 11SI Tntperrity Tpnt F21CCR 26 <br /> Annual MIR Re"ny-i- r,�PArry? '-')rAr (rr) 1 <br /> Ngtgrg Calibrated r23CCR 26AE (j) ] <br /> naillz Stick Reading [23CCR 2646 (c) (J ) j <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> Ex-Variat-ion'"'P-rbt-6dUie-Fo-lIowe a [23CCR 2646 (e) j <br /> LIAST19H (SIR) <br /> Inconclusive Procedure Followed [23CCR 2646.1 (d) ] <br /> UST Integrity Test Every Two Years [23CCR 2646.1 (q) ] <br /> Annual SIR Report [23CCR 2646.1(j) ] <br /> Da1Iy SticR Reading [23CCR 2646 (c) (1) j <br /> =GINO (ATG) <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> An-nuaI ATG Summary-Report L23CCR 2712 (JD) (2) j <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> An-TiU&I an Integrity 'I'est L23CCR 2645 (T)) I <br /> anx Ga ging Proceaure FoJ.Lo­we-ff--j73= 2645 (a) <br /> RIPING KONITORING <br /> Daily auctign Piping Monitoring [23CCR ADo.II1 <br /> Piping Tightness Test [23CCR 2643 (b) , �c) , (d) ] <br /> Gravity Pi in Tested Every 2 Years [23CCR 2643 (e) ] <br /> Monthly Line Test L23CCR 2643 (c) (2) ] <br /> =uaI l:;ea1C-De1CeCtD-r-TeSr--[23CCR 2630 (d) ] <br /> TANK REMOVAL <br /> Permit to Close or Cease Operation [H&SC 252981 <br /> rZemovea,IC ose r Tempoly CIosed [23CCR 26701 <br /> A <br /> L11 JL <br /> REHS to I INSPECTION DATE/TYPE: <br /> RECEIVED B PHONF,>47 <br /> Revised Da e 7/15/97 23 CCR UST Regs May 5, 1994 PAGE__/ of---S <br /> PHS 239(9/97) <br />