Laserfiche WebLink
UNDERGROUTANK PROGRAM OFFICIAL INS�TION REPORT <br /> AN JOAQUIN HEALTH DISTRIC <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME 3 q STOCKTON, CA 95205 COUNTY # <br /> PHONE NO. 468-3423 <br /> SITE NAME: mG.r-d-LR g LR0 INSPECTION DATE: 31 3i )S(j <br /> SITE ADDRESS: L Z� L-OLk2�vcQ CITY/STATE/ZIP L pig j Cz <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK TANIK <br /> FORM AAND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTIONSITE COM{{PUTER# PER# PER# PER# PER# <br /> Il'e)�_cc LL CM\ 1 3 EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR 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 <br /> APPROVED MONITOR FREQUENCY 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ACCESS CASING SECURED 17 18 <br /> PIPING 19 20 <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 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 W4142 <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED POWER DISCONNECTED OWNER/OPERATOR MONITORING <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALSR48 <br /> 47 ,.. .. . . <br /> PIPING FLAMMABLE VAPORS REMOVED UNAUTHORIZED RELEASE 5 <br /> SAMPLING 153 54 <br /> IMPROPER ABANDONMENT 155 156 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: --See, e <br /> 58 <br /> MAJOR 57 MINOR NO 59 <br /> VIOL. VIOL ❑ . VIOL.❑ <br /> OFFICE: INS �C RECEIVED BY: <br /> TITLE: '� J PHONE: BECK: <br /> HUT-3 ORIGINAL seas ©M <br />