Laserfiche WebLink
UNDERGROU�Aff TANK PROGRAM OFFICIAL INSPF" ION REPORT <br /> WSAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> STOCKTON, CA 95205 COUNTY # 3 ? <br /> COUNTY NAME �j / 0 /J PHONE NO. 468-3423 <br /> J <br /> SITE NAME: /„ INSPECTION DATE: <br /> SITE ADDRESS: Op/ CITY/STATE/ZIP C <br /> CHANGES SITE/OWNER/PER/MIT? YES NO TANK TANK TANKTANK �9 <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTE COMPUTE <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER # PER# PER# PER # <br /> EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> O ERATIONAL 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 S _ <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 _ <br /> APPROVED TANK REPAIRS 131 132 <br /> UNAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD 35 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL W43 <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED <br /> POWER DISCONNECTED OWNER/OPERATOR MONITORING <br /> x <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 49 _. <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 52 - .. .. .. <br /> SAMPLING 53 54 -- <br /> IMPROPER ABANDONMENT 55 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> 58 59 <br /> MAJOR 67 MINOR NO <br /> VIOL. VIOL. VIOL. <br /> OFFICE: INSP:p�r/s /rRECE B < v <br /> TITLE: 11 J7 PHON BECK: <br /> HUT-3 ORIGINAL 5/88 0 <br />