Laserfiche WebLink
UNDERGROI'"D TANK PROGRAM OFFICIAL INS"".CTION REPORT <br />SAN JOAQUIN HEALTH DISTRIC ■,r <br />1601 E. HAZELTON AVE. <br />STOCKTON, CA 95205 COUNTY # <br />COUNTY NAME PHONE NO 468-3423 <br />SITE NAME: <br />V <br />INSPECTION DATE: D- ^ 9Z' - <br />Z' -SITE <br />SITE ADDRESS:LGGCITY/STATE/ZIP-53'7 <br />CHANGES SITE/OWNER/PERMIT? YES <br />NO <br />TANK <br />TANK <br />TANK <br />TANK <br />FORM A AND/OR B SUBMITTED? <br />COMPUTER <br />COMPUTER <br />COMPUTER <br />COMPUTER <br />NUMBER <br />NUM <br />PER r 1/ <br />EXP. DATE V <br />NUMBER <br />PER # <br />EXP. DATE <br />NUMBER <br />PER # <br />EXP. DATE <br />PER # <br />EXP. DATE <br />TYPE OF N I SITE COMPUDR # <br />[I (G�///j <br />OPE TIONAL TANK TANK CONTENTS <br />MAJOR MINOR <br />.:- <br />PERMIT TO OPERATE 1 <br />2 - <br />CHANGE IN CONDITIONS TO OPERATE 3 <br />4 <br />APPROVED CONSTRUCTION 5 <br />6 <br />WRITTEN MONITORING PROCEDURES 7 <br />8 <br />APPROVED MONITORING SYSTEM 9 <br />10 <br />MONITORING SYSTEM 11 <br />12 <br />APPROVED MONITOR FREQUENCY 13 <br />14 <br />MONITORING RECORDS MAINTAINED 15 <br />16 <br />ACCESS CASING SECURED 17 <br />18 <br />— <br />PIPING 19 <br />20- <br />INVENTORY RECONCILIATION 21 <br />22 <br />TANK GAUGING 23 <br />24 <br />APPROVED RESPONSE PLAN 25 <br />26 <br />UNAUTHORIZED RELEASE OCCURRENCE 27 <br />28 <br />SAMPLING 29 <br />30 <br />_ <br />- -- <br />APPROVED TANK REPAIRSN37 <br />UNAUTHORIZED RELEASES REPORTED <br />SAFETY HAZARDCONDITIONS <br />ABATED <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL I38 <br />139 <br />FLAMMABLE VAPORS REMOVED <br />ACCESS LOCATIONS SEALED <br />w-7 <br />POWER DISCONNECTED <br />OWNER/OPERATOR MONITORING <br />PERMANENT TANK CLOSURE <br />REMOVAL OF RESIDUAL MATERIALS 46 <br />47 <br />---- <br />PIPING 48 <br />49 <br />FLAMMABLE VAPORS REMOVED 50 <br />_ <br />UNAUTHORIZED RELEASE 51 <br />52 <br />SAMPLING 53 <br />54 <br />IMPROPER ABANDONMENT 55 <br />56 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />SYSTEM STATUS (MUST MARK ONE) <br />FOLL <br />57 58 59 <br />MAJOR MINOR NO <br />❑ E] <br />VIOL. VIOL VIOL <br />RECEIVED BY- <br />QtGG <br />OFFICE: <br />INSP- / oe <br />TITLE: / <br />PHOW. <br />RECK: <br />HUT -3 <br />ORIGINAL Sias O <br />