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UNDERGROUN" TANK PROGRAM OFFICIAL INSPE'TION REPORT f U f 3 <br /> _SAN JOAQUIN HEALTH DISTRICT v - <br /> 1601 E. HAZELTON AVE. ^- <br /> COUNTY NAME STOCKTON, CA PHONE NO. 468 3423 205 COUNTY # <br /> SITE NAME: C - ./ _ INSPECTION DATE:/6 0 <br /> SITE ADDRESS: "/ Q �u ,, �p CITY/STATE/ZIP5 - ��Z® b <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK 1Z, TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE/C/O_ /MPUTER# PER# PER# PER# PER# <br /> v q ` EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR I MINOR <br /> PERMIT TO OPERATE 1 2 <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 W4445 <br /> FLAMMABLE VAPORS REMOVED <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 <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 /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> MAJOR 57 MINOR NO 5958 <br /> / <br /> VIOL. ❑ VIOL ❑ VIOL <br /> OFFICE: INSP:�fz4jt4,VCt7 RECEIVED BY: <br /> TITLE: u s PHONE: BECK: <br /> HUT-3 ORIGINAL 5ia8 O <br />