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UNDERGROUNT TANK PROGRAM OFFICIAL INSPE,TION REPORT <br /> `,oAN JOAQUIN HEALTH DISTRICT _ <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME Jc rlToct u n `' I�1�.���STOCKTON, CA 95205 COUNTY # 3 <br /> Re44 "&=0NE NO. 468-3423 <br /> SITE NAME: ( C T ►Y O ZW7 ( INSPECTION DATE: <br /> SITE ADDRESS: 35 Ce-r �I CITY/STATE/ZIP Trac <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK QYJ 1 I TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER y�A/ OMPUTER COMPUTER COMPUTER <br /> NUMBER-7 NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER# 13`1S'00 UI PER# PER# PER# <br /> 5- EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR I MINOR <br /> PERMIT TO OPERATE 1 12 <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 <br /> APPROVED CONSTRUCTION 5 6 _ <br /> WRITTEN MONITORING PROCEDURES 7 8 <br /> APPROVED MONITORING SYSTEM 9 10 <br /> MONITORING SYSTEM 11 12 <br /> APPROVED MONITOR FREQUENCY 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ACCESS CASING SECURED 17 18 <br /> PIPING 19 20 <br /> INVENTORY RECONCILIATION 21 22 <br /> TANK GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 25 26 <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 28 <br /> SAMPLING 29 30 <br /> APPROVED TANK REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 3B 39 <br /> FLAMMABLE VAPORS REMOVED ;44r <br /> ACCESS LOCATIONS SEALED _ <br /> POWER DISCONNECTED <br /> OWNER/OPERATOR MONITORING <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 49 <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 53 54 <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED ITEMS-REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> -�- <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: I Z 0 v �t- <br /> MAJOR 57 MINOR NO 59rze <br /> VIOL. Li VIOL. ❑ VIOL <br /> OFFICE: INSP. t RECEIVED BY: <br /> TITLE:�f+ PHONE: RECK: <br /> HUT-3 ORIGINAL sine OM <br />