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UNDERGRQUIAN TANK PROGRAMOFFICIAL DSTRIC TION REPORT JOAQU N HEA 1604 E. HAZELTON AVE. ''I STOCKTON, CA 95205 COUNTY # COUNTY NAME�?�� v PHONE NO. 468-3423 SITE NAME: INSPECTION DATE: SITE ADDRESS: �, �� / CITY/STATE/ZIP -tD CHANGES SITE/OWNER/PERMIT? YES NO TANK p 1 TANK �? L TANK D3 TANK FORM RAND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER NUMBER NUMBER NUMBER NUMBER TYPE OF INSPECTION SITE COM TER# PER# PER# PER # PER# 1 2> EXP.DATE EXP.DATE EXP DATE EXP DATE - r TANK CONTENTS OPERATIONAL TANK MAJOR MINOR PERMIT TO OPERATE 1 2 CHANGE IN CONDITIONS TO OPERATE 3 4 -- APPROVED CONSTRUCTION 5 6 -- -- - WRITTEN MONITORING PROCEDURES 7 8 APPROVED MONITORING SYSTEM 9 10 _ --- MONITORING SYSTEM 11 12 APPROVED MONITOR FREQUENCY 13 14 MONITORING RECORDS MAINTAINED 15 16 ACCESS CASING SECURED 17 18 PIPING 19 20 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 — M UNAUTHORIZED RELEASES REPORTED 33 134 --- SAFETY HAZARD 35 136 �.._ CONDITIONS ABATED 37 TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 38 39 FLAMMABLE VAPORS REMOVED 40 — ACCESS LOCATIONS SEALED 41 42 - — - POWER DISCONNECTED m 43 _.- OWNER/OPERATOR MONITORING 144 45 PERMANENT TANK CLOSURE REMOVAL OF RESIDUAL MATERIALS 46 47 -- -- — .-- PIPING 48 49 FLAMMABLE VAPORS REMOVED 50 UNAUTHORIZED RELEASE 51 52 _ -- - - SAMPLING 53 54 _ IMPROPER ABANDONMENT 55 56 THE MARKED ITEMS PIEPRESENT VIOLATIONS AND MUST E CORRECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS:57 MAJOR MINOR 5NO 59 it VIOL. VIOL. VIOL.O OFFICE: INSP RECEIVED BY: �► TITLE: PHONE: BECK: (2-05T�2/ V _ 5�as O HUT-3 ORIGINAL