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vN <br /> COUNTY NAME <br /> SffE NAME: Q, INSPECTION DATE: <br /> SITE ADDRESS /SrokTE/ZIP <br /> UV44UFZS SITE/OWNER/PERMIT? YES NQ TAMC TAMC 1ANK TANK <br /> MFR/PERMIT SUBMITTED <br /> l <br /> D• CJD♦ ` - IDI of <br /> i +MtSPECTXJN SITE COMPUTER• PER 0 PER 0 PER 0 PER i <br /> / k EXP.DATE 1EXROATE EXP.OWEEXP.DATE y <br /> OPERWMAL TANK MA.L AKIN. <br /> PEAW M OPERATE 1 2 <br /> CHANGE IN OONMI NS TO OPERATE 3 4 <br /> APPROVED CONSTRUCTION 6 8 <br /> YVRTTEN MONRDmm PROCEDURES 7 B <br /> APPROVED MONnDR1N0 SYSTEM Y 10 <br /> MONRORMX3SYSTEM 11 12 <br /> APPROVED MWtOR FREQUENCY 13 14 <br /> MONRORINO RECORDS MAINTAINED IS lie <br /> ACCESS CASINO SECURED 17 18 <br /> PIO 19 1201 <br /> INVENTORY RECONCILIATION 21 22 <br /> TANK GALX3M <br /> 231 1241 <br /> 1- <br /> APPROVED RESPONSE PI.MI2I _ <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; 361 1 <br /> CONOTTIONS ABATED J7 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 <br /> OWNER/OPERATOR MONITORING 44, 45 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 461 47 <br /> PIPING 46[ 49 1 <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE St 52 <br /> SAMPLING 53 54 <br /> IMPROPER ABANOONMENT 55 58 L <br /> THE MARKED ITEMS PRESENT VIOLATIONS AND MUST BE D AS- <br /> SYSTEM STATUS(MUST MARK 004E) FOLLOWS: �'I^�(.u.✓- -G�\J _ <br /> MAJOR 67 "NOR 58 50 <br /> VIOL ❑ VIOL_ Ej VIOL❑ <br /> R56KPN LOCAL HEALTH DISTRII NSP: RE IVSD <br /> STOCKTON.POST CALIF.O9 <br /> 5207 � � <br /> N: ENVIRON. HEALTH PHONE: RECK <br /> T/1T/N o- <br />