Laserfiche WebLink
UM6ERGROUND TANK OFFICIAL INSPECTION REPORT <br /> SAN JOAQUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 445 N.Sen Joaquin Street <br /> Meiling Address: P.O.Box 388 <br /> COUNTY NAME, U 6toc"O4683szool-ossa COUNTY # <br /> SITE NAME: E�ml" /f VI t�ecttAU INSPECTION DATE: arj r SITE ADDRESS: -3ug s , to Z)d-� CITY/STATE/ZIP �6G� � 0-4 15 <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK ( TANK 2 TANK 3 TANK 176 <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER <br /> -r A)K/1 � PER# PER# PER# PER# <br /> I �f l� 3 11-) ;? <br /> �O - EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK conreNis <br /> MAAJOR MINOR a Oi <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 16Df- <br /> - <br /> ACCESSCASINGSECURED 17 16 . l •, a —�z) <br /> PIPING 19 20 I J I <br /> INVENTORY RECONCILIATION 21 22 <br /> TANK GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 25 26 <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 28 <br /> SAMPLING 29 130 <br /> APPROVED TANK REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED 33 134 <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> Al <br /> REMOVAL OF RESIDUALW44 -7- <br /> 39 <br /> FLAMMABLE VAPORS REMOVED ACCESS LOCATIONS SEALED POWER DISCONNECTED 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 b ✓ Se.rJA�h' V <br /> SAMPUNG 53 54 a ab -0b5P!'t/4�` <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS:MINOQ <br /> 57 58 59 <br /> VIOL." LJVIOL LJ VOL❑ <br /> OFFICE: INSP: RECEIVED BY: <br /> S'6Nia12 �1l1 <br /> TITLE: PHONE: RECK: <br /> HUT-3 White-Orininsl Yellow-Owner's Coov Pink-File Coov - ,... <br />