REMOVAL REMOVAL 1989 - Laserfiche WebLink

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UNDERGROU�ANK PROGRAM OFFICIAL INSP AN JOAOUIN HEALTH DISTRICT ION REPORT COUNTY NAME 1601 E. HAZELTON AVE. STOCKTON, CA 95205 SITE NAME: PHONE NO. 468-3423 COUNTY # SITE ADDRESS: W16YAINSPECTION DATE: CHANGES SITE/OWNE PERMIT? CITY/STATE/ZIP n YES NO TANK B 0 FORM A AND/OR B SUBMITTED? TANK TANK TY P OF INSPECTION -� COMPUTER COMPUTER COMPUTER TANK SITE CO COMPUTER# NUMBER NUMBER COMPUTER PER# PER# NUMBER PER# NUMBER OEXP.DATE PERATIONAL TANK TANK CONTEN75 EXP.DATE EXP.DATPER#E PERMIT TO OPERATE MAJOR MINOR EXROATE CHANGE IN CONDITIONS TO OPERATE 1 2 APPROVED CONSTRUCTION 3 4 WRITTEN MONITORING PROCEDURES 5 6 APPROVED MONITORING SYSTEM 7 8 MONITORING SYSTEM 9 10 APPROVED MONITOR FREQUENCY 11 12 13 14 MONITORING RECORDS MAINTAINED 15 16 ACCESS CASING SECURED 17 18 PIPING 19 -- INVENTORY RECONCILIATION 21 22 _ TANK GAUGING 23 24 APPROVED RESPONSE PLAN 25 26 UNAUTHORIZED RELEASE OCCURRENCE 27 28 SAMPLING 29 30 APPROVED TANK REPAIRS 31 32 ' UNAUTHORIZED RELEASES REPORTED 33 34 SAFETY HAZARD 35 36 - - CONDITIONS ABATED 37 TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 38 39 FLAMMABLE VAPORS REMOVED 40 ACCESS LOCATIONS SEALED 41 - POWER DISCONNECTED 42 OWNER/OPERATOR MONITORING43 44 45 PERMANENT TANK CLOSURE REMOVAL OF RESIDUAL MATERIALS PIPING 46 47 FLAMMABLE VAPORS REMOVED 48 49 UNAUTHORIZED RELEASE50 '- ----- SAMPLING 51 52 IMPROPER ABANDONMENT 53 54 -- -- 55 56 YSTEM STATUS(MUST MARK ONE) THE MARKED ITEMS REPRESEM VIOLATIONS AND MUST BE CORRECTED AS FOLLOWS: MAJOR 57 MINOR 58 NO 59 VIOL VIOL VIOL FFICE: INSP: ak7 L /---z)/ RECEIVED BY: TITLE: �/j PHONE: 7�Gtt�j / RECK: T-3 ORIGINAL sae oM