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UNDERGROU -6 4NK PROGRAM OFFICIAL INSPEC' -)N REPORT <br /> N JOAQUIN HEALTH DISTRICT ,� <br /> �� 1601 E. HAZELTON AVE. <br /> STOCKTON, CA 95205 COUNTY # <br /> COUNTY NAME PHONE N0. 468-3423 <br /> INSPECTION DATE: <br /> SITE NAME: <br /> CITY/STATE/ZIP Z o <br /> SITE ADDRESS: `�C �AJ , <br /> CHANGES SITE NO TANK <br /> TANK TANK TANK <br /> FORM AAND/OR B SUBMITTED? COMPUTERO COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER# PER <br /> 2-2-SbEXP <br /> # PER# <br /> EXP.DATE EXP.DATE EXP.DATE EXP DATE <br /> IIJM CONTENTS <br /> OPERATIONAL TANK AOR 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 FREOUENCY 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 38 39 .. <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 _. <br /> POWER DISCONNECTED 43 <br /> OWNER/OPERATOR MONITORING 44 45 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS r46 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 FORRECTED AS <br /> SYSTEM STATUS(MUST MARK OgNE) FOLLOWS: e01� <br /> MAJOR O MINOR rl/ 59 <br /> VIOL VIOL LTJ VIOL. <br /> OFFICE: INSP:w-ex / REC IVIED BY <br /> TITLE: r-> L/ PHONE. BECK: <br /> HUT-3 r _ ORIGINAL 5/86 n <br />