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COUNTY NAME • 51 "3 <br /> SITE NAME: n Gl/ 7C IC K3dE ) INSPECTION DATE: <br /> SITE ADDRESS �/ j 3U (J. � 1/I?LC� ,Q� Cmr/SD1TE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? NO TANK TANK TANK TANK <br /> MFR/PERMIT SUBMITTED e4 ESPDO o+ o• C' n O s Of <br /> .0 TVAi OF*WEC110N • PER 0 PER I PER• PER• <br /> EXP DATE EXP.WE EXP.DATE EXP.DATE <br /> OPEPUCKWAI.TANK MIA.. MdN. <br /> PERMIT TO OPERATE 1 2 <br /> CHANGE IN CONDITIONS TO OPERATE 4 <br /> APPROVED CONSTRUCTION 6 6 <br /> WRITTEN MOMIDRING PROCEDURES 7 E <br /> _ APPROVED MONITORING SYSTEM 9 10 <br /> MONRORRNO SYSTEM 11 12 <br /> APPROVED MONITOR FREOIIENCY 131/ 14 .i ✓ <br /> MONITORING RECORDS MAINTAINED 15 I/ 18 .� v ✓ <br /> ACCESS CASING SECURED 17 tB <br /> PIPING 19 20 <br /> INVENTORY RECONCILIATION 2V L 22 ,i <br /> TANK GAUGING 23 24 <br /> I APPROVED RESPONSE PLAN 25 28 <br /> la UNAUTHORIZED RELEASE OCCURRENCE 27 28 <br /> SAMPLING 29' 301 1 <br /> APPROVED TANK REPAIRS 31 32 <br /> IANAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD . . 361 1 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 36 39 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED43 <br /> OWNER/OPERATOR MONRORING N l5 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 461 47 <br /> PIPING 4849 <br /> FLAMMABLE VAPORS REMOVED 501 M <br /> UNAUTHORIZED RELEASE 111 52 <br /> SAMPLING 531 54 <br /> IMPROPER ABANDONMENT 551 59 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONEI FOLLOWS. <br /> Ya V a viol a <br /> 9569�UN LOCAL HEALTH DISTRI NSP: `yv RECEIVED BY: <br /> POST OFFICE BOX 2009 <br /> STOCKTON. CALIF. 95201 <br /> N: ENVIRON. HEALTH TITLE, �.,� PHONE' RECIC <br />