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UNDERGROUf�TANK PROGRAM OFFICIAL INSP�TION REPORT <br /> USAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY <br /> PHONE NO. 468-3423 <br /> SITE NAME: �' , ` INSPECTION DATE: 8a/ �! <br /> SITE ADDRESS: �IV�J uJ[N� ,� �� U �(! CITY/STATE/ZIP Sf C1'4 <br /> CHANGES SITE/OWN /PERMIT? YES NO TANK TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER# PER# PER # PER# <br /> r /A 3 CO EXP.DATE EXP.DATE EXP.DATE_ EXP.DATE <br /> OPERATIONAL TANK TANKCONTtNTs <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 11 12 <br /> APPROVED MONITOR FREQUENCY 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 v <br /> ACCESS CASING SECURED 17 18 O <br /> PIPING 19 20 <br /> INVENTORY RECONCILIATION 21 22 1 <br /> TANK GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 25 26 ` <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 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 138 39 <br /> FLAMMABLE VAPORS REMOVED <br /> V43 <br /> ACCESS LOCATIONS SEALED POWER DISCONNECTED OWNER/OPERATOR MONITORING <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 56 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: - <br /> MAJOR 57 MINOR 58 NO 59 <br /> VIOL. LJ "'OL." ❑ VIOL.❑ — ' <br /> OFF <br /> TITL�� ONE: RECK: <br /> HUT-3 OWNER'S COPY 5/88 ©M <br />