Laserfiche WebLink
U*,OkRGROUND TANK OFFICIAL INSPECTION RVOORT <br /> SAN JOAQUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 445 N.San Joaquin Street <br /> r Melling Address: P.O.Box 389 <br /> COUNTY NAMEStockton,CA 95201.0388 COUNTY # j <br /> 498-3420 <br /> SITE NAME: /r l E(J U (� f�� T INSPECTION <br /> a DATE: Y-5- <br /> SITE ADDRESS: CITY/STATE/ZIPSK�Z /S , <br /> 9-.)d Q<J <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INS CTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER <br /> 7p � 12 PER# PER# PER# PER# <br /> lig EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPER TIONAL TANK TANKC 1475 <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 <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 29 130 <br /> APPROVED TANK REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED 33 134 j,[ng k <br /> SAFETY HAZARD 35 36 _ <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL W44459 <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED <br /> POWER DISCONNECTED <br /> OWNER/OPERATOR MONITORING <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 49 <br /> FLAMMABLE VAPORS REMOVED 50 m . r T <br /> UNAUTHORIZED RELEASE 51 52 A)O I es f I YL <br /> SAMPLING 53 ✓ <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS IMUST MARK ONE) FOLLOWS: <br /> I <br /> MAJOR 57 MINOR 58 NO 59 <br /> VIOL. VIOL. ❑ VIOL❑ <br /> OFFICE: INS`P�' ECEIVED BY: <br /> ��/I.fi�LC--�L ✓ <br /> TITLE: PHONE: BECKRE H : <br /> H11T-3 WP.ae-Ork incl Yellow-Owner's Copy Pink-File Copy <br />