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0 6 <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 /> UNDERGROUND TANK PROGRAM OFFICIAL INSPECTION REPORT <br /> Facility Name V_ LJApkt+- Facility ID# <br /> Facility Addres j SZg u3 dU.;ti -sA- City �Ad Zip s <br /> 49SA! <br /> Facility Phone # Facility Contact J� r-9- le—AX ,c�n f7 <br /> Inspection Date: Inspection Type: 9=604aa- <br /> UST: Dual Waller Single Wall_ OVERFILL: Audible-- Visual <br /> UST Monitoring Alternative .wJA�WOCA t7 UST Contents�1 -asa wr— <br /> PIPING SYSTEM: Dual Wall Single Wall Suction x Pressure Gravity <br /> Does the leak de ection system shut off the pump automatically? YES_ NO <br /> VIOLATIONS <br /> TANK # <br /> UST GENERAL REQUIREMENTS _ _ - <br /> Permit to Operate [H&S 252841 <br /> orms A & B current c <br /> Monitoring/Maintenance Records L23CCR 2712 (b) j <br /> Financial Responsi.bi ity LH&S 25292.2 (a) ] <br /> Monitoring Recoras AvailaiDle <br /> Monitoring Plan <br /> Response Plan 23CCR 2632 (d) (2) ] <br /> Unauthorized Releases Reported H&S 25295 <br /> Monitoring Equipment Annual Test L23CCR 2630 <br /> over spili Container <br /> Permitted UST Repairs 23CCR 2661 <br /> Permitted Upgrades [23CCR 26601 <br /> Cathodic ro ec i.on a <br /> MANUAL INVENTORY RECONCILIATION MIR <br /> UST Integrity Test [23CCR 2643.1] <br /> Annual MIR Report 23CCR 2646 <br /> Meters Calibrated [23CCR 2646 (e) (4) ] <br /> Dailv Stick readincr L23CCR 44 c 1 <br /> Gau in Stick in 1/8 inches [23CCR 2646 (c) (1) (E) ] <br /> STATISTICAL INVENTORY RECONCILIATION SIR <br /> Excessive Variation Reported 23CCR 2646.1(d) <br /> UST Integrity es every two years <br /> Zb4b.17g77— <br /> Annual SIR Report L23CCR 2646.1 <br /> Daily Stick Reaaing c <br /> AUTOMATIC TANK GAUGING ATG <br /> Monthly ATG Results [3CCR 2643 (b) (1) ] <br /> Annual ATG Summary Report 23CCR 2712 b 2 <br /> MANUAL UST TANK GAUGINGMT <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> Annua Tank Integrity Test L23CCR 2645 b <br /> PIPING MONITORING <br /> Daily Suction Piping Monitoring [23CCR APP.III <br /> Piping Tightness Test [23CCR 2643 (b) , (c) , (d) ] <br /> Gravity Piping este ever ears e <br /> Monthly Line Test L23CCR 2643 c 2 <br /> Annuai LeakDetector test L23CCR App.lV(1) (d) j <br /> SYSTEM STATUS: Major Violations No Violations <br /> COMMENTS: 2- <br /> REH RECEIVED BY: <br /> TITLE: V1" PHONE: DATE: <br /> Revised Date 1/29/97 23 CCR UST Regs May 5, 1994 <br />