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IV <br />I. [N I T IVAML J <br />K <br />SITE NAME: Z V. <br />INSPECTION DATE: <br />SITE ADDRESS: <br />CITY/STATE/ZIP F o- <br />CtW4GES SfTE/OWNER/PERMIT? <br />MER/PERMfT <br />YES <br />NO <br />TANK TANK Z TANK 2 � <br />SU lMfTTEO <br />I J �L <br />TYPE Of IIISPEGTTON SITE COMPIJiER • <br />-J -;a, q • (- <br />PpEFl �U.. �,ecvQe�T p • `f. Ucxj ��.0 D ♦ <br />PER • 0� LXXJ <br />J PER • 1125£X. � 0- <br />, , C, 7 <br />EXP. DATE. EXP. DATER EXP. DATE EXP.ONE <br />OPERATIONAL TANK <br />MAV. <br />MIN. <br />PERI.fT TO OPERATE <br />1 <br />2 <br />CHA"GE IN CONDITIONS TO OPERATE <br />3 <br />M <br />APPROVED CONSTTiUCTION <br />5 <br />6 <br />WFifTTEN MONRORkq PROCEDURES <br />7 <br />B <br />APPROVED MONITORING SYSTEM <br />0 <br />10 <br />MONTORING SYSTEM <br />I t <br />12 <br />APPROVED MONITOR FREQUENCY <br />IJ <br />tt <br />MONITO W40 RECORDS MM(TAINED <br />15 <br />16 <br />ACCESS CASINO SECURED <br />17 <br />16 <br />PIPING <br />IB <br />20 <br />".IENTORY RECONCUATICN <br />21' <br />22 <br />TANK GAUGING <br />27 <br />24 <br />APPROVEO RESPINSE Pt AN <br />2S <br />28 <br />UNAUTHORIZED RELEASE OCCURRENCE <br />27 <br />211 <br />SAMPLING <br />29' <br />JO <br />APPROVED TANK REPAIRS <br />J1 <br />J21 <br />UNAUTHORIZEO RELEASES REPORTED <br />33 <br />31 <br />SAFETY HAZARD <br />J5. <br />061 <br />CONOMONS ABATED <br />7 <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL <br />38. <br />A <br />FLAMMABLE VAPORS REMOVED <br />NO <br />ACCESS LOCATIONS SEALED <br />N 1 : <br />42 <br />POWER DISCONNECTED <br />ONNEWOPERATOR MOMTORING <br />44 <br />451 <br />PERMANENT TANK CLOSURE <br />REMOVAL OF RESIDUAL MATERIALS <br />461 <br />47 <br />i <br />PIPING <br />46 <br />49 <br />FLAMMABLE VAPORS REMOVED <br />50 <br />UNAUTHORIZED RELEASE <br />111 <br />52 1 <br />ul <br />SAMPLING <br />S31 <br />54 <br />IMPROPER ABANDONMENT <br />55156 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />SYSTEM STATUS (MUST MNK ONE1 <br />S7 <br />MAJOR 58 59 <br />MINOR ND <br />FOU.OWS %V <br />C <br />❑ <br />a <br />WA6 UN LOCAL HEALTH DISIR11 <br />NSP: <br />RECENED BY: <br />POST OFFICE GOX 2009 <br />/- <br />STOCKTON. CALIF. 95201 <br />�� <br />{ <br />licat <br />PViO"EPECK <br />ATTN: ENVIRON. HEAN TH <br />IV <br />