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UNDERGROUI TANK PROGRAM OFFICIAL INSP' TION REPORT <br /> - SAN JOAQUIN HEALTH DISTRICT - <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAMEC ^ T STOCKTON, CA 95205 COUNTY # <br /> JlM I U (�Q ((�� PHONE NO. 468-3423 39 <br /> SITE NAME: Rhx S i� xnduvri I i„i„ A,.. �jC INSPECTION DATE: �•_ -C�� <br /> SITE ADDRESS: DDµ �V, C-' Ddrad�(•wf f`� CITY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? YES LNJO TANK TANK p2 TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER# PER# PER# PER# <br /> 'C)q/ EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONRe <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 y' <br /> APPROVED MONITOR FREQUENCY 1 14 -I— '1 <br /> MONITORING RECORDS MAINTAINED 1 16 ,r <br /> ACCESS CASING SECURED 17 18 <br /> PIPING 19 20 - <br /> INVENTORY RECONCILIATION 2 22 <br /> TANK GAUGING 2 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 W43 <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED <br /> 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 <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: e C ,M- <br /> MAJOR X57 MINOR 58 NO 59 <br /> VIOL. 1XJ VIOL ❑ VIOL❑ <br /> OFFICE: INSP: P�adO��Q �EWREh? / 7`0 <br /> "4 /95 c FIO�R f S#- �OGCf7YL �A %;�-DS <br /> TITLE: �,�,S', PHONE: RECK: <br /> HUT-3 ORIGINAL 5/88 01 <br />