Laserfiche WebLink
r UNDERGROU ' TANK PROGRAM OFFICIAL INSPE"DON REPORT <br /> AN JOAQUIN HEALTH DISTRICT <br /> y 1601 E. HAZELTON AVE. <br /> COUNTY NAME claa U{N STOCKTON, CA 95205 <br /> 4LtN PHONE NO. 468-3423 COUNTY # Z..� <br /> SITE NAME;. wi N @vo INSPECTION DATE: f ��$ /�r�qr <br /> SITE ADDRESS: �ZNN n�� �� E� N^t6CITY/STATE/ZIP C;4 53 0 <br /> 53 d_0 <br /> ! l <br /> CHANGES SITE/OWNER/PERMIT? YE <br /> No TANK TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? h.)(") COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER <br /> Id ( ti1dJJ fa PER # PER# PER# <br /> 4'17 11 PER # <br /> IOEXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERA NAL 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 8 <br /> APPROVED MONITORING SYSTEM 9 10 -- <br /> MONITORING SYSTEM <br /> 1 12 <br /> APPROVED MONITOR FREQUENCY 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ACCESS CASING SECURED <br /> 17 18 <br /> PIPING <br /> 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 Z2 <br /> 30 <br /> APPROVED TANK REPAIRS <br /> 31 32 <br /> UNAUTHORIZED RELEASES REPORTED33 34 — <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL W4.445 <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED <br /> POWER DISCONNECTED <br /> OWNER/OPERATOR MONITORING <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS CTHE <br /> PIPING FLAMMABLE VAPORS REMOVEDUNAUTHORIZEDRELEASE SAMPLING IMPROPER ABANDONMENT I__ REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: \ &,- �[, ;z y4 �e�. <br /> 6 <br /> 58 0�7 ° _K Q v r Q S�#M1 �"a prJ d r.a <br /> MAJOR 57 MINOR NO 59 4aar'0 5'dl L Of( ersfUe,'w"l SEQ. Cd Juuet�aON <br /> VIOL. ❑ VIOL. ❑ VIOL. 522 a� { QfWt 1Pi- <br /> OFI=ICE: INS � RECEIVED BY: <br /> TITLE: �> Gr{ PHONE: BECK: <br /> IUT-3 ORIGINAL siss 0 <br />