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lw <br /> ca COUNTY NAME • 3 <br /> SITE NAME: S�a fh A/ PA4u 7j.�ArSlb z-/-,A--7/ ' INSPECTION DATE: /C)�8A <br /> SITE ADORESs: 7 f/ j%L( Z S T CRY/STrTE/ZIP <br /> CHANGES SITE/OWNER/PERMIT7 YES NO TANK ie o,,, d TANK TiWC TANK <br /> MFA/PEF MIT SUBMITTED 100 <br /> /�� o I 10• A• <br /> TYPE cw lt9PECTION SITE COIAPUiEgR 0 PER•" _ "" PER♦ PER PER <br /> ..7 Elm GATE EXP.DATE E7.Wn EXP GATE <br /> OPERATIONAL TANK MAJ. IAN. <br /> Po"T TO OPERATE 1 121 <br /> CHANW N CONDITIONS TD OPERATE <br /> APPROVED OONSTAUCTTON 6 161 <br /> V,TWMN MONITORING PROCEDURES 7 151 <br /> APPROVED MONITOR W SYSTEM 9 1,01 <br /> L4oNITORNG SYSTEM 11 12 <br /> APPROVED MONITOR FREGU)ENCY 13 14 <br /> MONMORNG RECORDS MARNTANED 15 16 <br /> ACCESS CASH SECURED 17 18 <br /> PIPING 19 20 <br /> INENTORY RECONCILIATION 21' 22 - <br /> TANK GALX714G 2324 <br /> APPROVVD RESWINSE PLAN 251 26 <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 20 <br /> SAMPLING 29' 30 <br /> VA <br /> APPROVED TANK REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD 35 38 <br /> CONOITKktS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RE SIOUAL wllr397FLAMMABLE MWORS REMOVED ACCESS LOCATKNS SEALED POWER DISCONNECTED OWNER/OPERATOR MON TORING <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 M14 PIPING91 <br /> FLAMMABLE VAPORS REMOVED UNAUTHORIZED RELEASE 2 <br /> SAMPLING JSJ I 154L__ <br /> K4PROPER ASANOONMENT SS56 <br /> THE MARKED ITEMS REPRE SEN�VIOLATIONS ANO MUST BE CORRECTED AS <br /> SYSTEM STATUS IM<7S1 MMK O+EI FOLLONVS(5O <br /> MAJOR 57 MINOR 59 El NO �5Q <br /> VOL VIOL VIOL C�1 <br /> ' Ry6K�#1N LOCAL HEALTH DIST RI NSR W RECEPVED BY: <br /> POST OFFICC BOX 2009 <br /> STOCKTON. CALIF. 95201 <br /> � PHONE: REG(. <br /> AJ-TN: ENVIRON. HEALTH TITLE: S, <br /> „�No o- <br />