Laserfiche WebLink
or er <br /> PUBLI EALTH SERVICES SAN JOAQ' - 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 Address ' '�''� (�� City <br /> UST: Dual Wall ,M- Single Wall OVERFILL: Audible Visual_Mechanical ,f <br /> PIPING SYSTEM: Dual wall ,/ Single wall Suction Pressure / Gravity <br /> DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636 (8) requirements? YES NO <br /> VIOLATIONS <br /> TANK # <br /> UST GENERAL REQUIREMENTS <br /> Permit to Operate [H&SC 252841 <br /> Forms A & B Current H&SC 25284 c <br /> Monitoring/Maintenance Records 23CCR 2712 (b) ] <br /> Monitoring Records Available 23CCR 2712 <br /> Monitoring Plan [23CCR 2632 (d) (1) <br /> Resuonse Plan r23CCR 2632 (d) (2) 1 <br /> Unauthorized Releases Reported [H&SC 25295] <br /> Monitoring Equipment Annual Cert. L23CCR 2630 <br /> Over spill on ainer L23CCR 2635 (b) ] <br /> Cathodic Protection 23CCR 2635 a 2 A <br /> New USTs Monitored Continuously [23CCR 2630] <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> TTAT Tntearitv Test [23CCR 2641-11 <br /> Meters Calibrked2 R 264 6 (1) 1 <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> x- ar a ion Procedure Followed L23CCR 2b4b (e) j <br /> STATISTICAL INVENTORY RECONCILIATION (SIR) <br /> Inconclusive Procedure Followed [23CCR 2646.1 (d) ] <br /> UST Integrity Test Every Two Years 23CCR 2646.1 <br /> Annual SIR Report [23CCR 2646.1(j) ] <br /> Daily Stick Reading (c) (1) j <br /> AUT MATIC TANK GAUGING (ATG) <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> nuasummary Report <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] S <br /> Annuai lankn egri y Iest <br /> lank uauging Proceaure kolloweCL <br /> PIPING MONITORING <br /> Daily uc i n Piping monitoring r2 R ADD.II1 <br /> Piping Tightness Test 23CCR 2643 b c d <br /> Gravity Piping Tested Every 2 Years [23CCR 2643 (e) ] <br /> Monthly Line Test L23CCR 2643 c 2 <br /> Annual e <br /> TANK REMOVAL <br /> Permit/'to )Close,or Cease Operation H&SC 25298 <br /> Remov se or Temporar y Closed 23CCR 2670 <br /> REHS INSPECTION DATE/TYPE: <br /> RECEIVED BY: PHONE: / <br /> .r <br /> Revised Date 7/15/ 7 23 CCR UST Regs May 5, 1994 PAGE-of- <br /> PHS <br /> AGEofPHS 231(9/97) <br />