Laserfiche WebLink
UNDERGROU TANK PROGRAM OFFICIAL INSP TION REPORT <br /> IWAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY # 3 <br /> PHONE NO. 468-3423 <br /> SITE NAME: ClJ�+9/�e/Gf4 INSPECTION DATE: <br /> SITE ADDRESS: CITY/STATE/ZIP Z <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK ( TANK TANK TANK <br /> FORM AAND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBE <br /> TY OF INSPECTION SITE COMPUTER# <br /> Ov ` PER#(L S-- O( PER# PER# PER# <br /> 6 J EXP.DATE EXP.DATE EXP.DATE EXP.DA E <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR LMINOR <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 /> _,_ <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 *33 <br /> APPROVED TANK REPAIRS UNAUTHORIZED RELEASES REPORTED SAFETY HAZARD CONDITIONS ABATED <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL W4445 <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED <br /> POWER DISCONNECTED <br /> OWNER/OPERATOR MONITORING <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 4647 <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: <br /> 58 gQ/ <br /> MAJOR 57 MINOR NO G <br /> VIOL. El VIOL ❑ VIOL. <br /> OFFICE: INSP. RE EIVED <br /> TITLE: �S PHC6V KECK- <br /> HUT-3 ORIGINAL siee O, <br />