COMPLIANCE INFO 1988-2013 - Laserfiche WebLink

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UNDERGROU�ANK PROGRAM OFFICIAL INSPE�j,ION REPORT AN JOAQUIN HEALTH DISTRICT 1601 E. HAZELTON AVE. COUNTY NAME STOCKTON, CA 95205 PHONE NO. 468-3423 COUNTY # 3 SITE NAME: /j V I,� INSPECTION DATElo,27 SITE ADDRESS: �j �r J ezov q/ S!j-(� CITSY AT /ZIP 9S-we, CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANKR TANK FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTECOMPUTE TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER R PER# PER# PER# gs PER# 7 EXP.DATE EXP.DATE EXP.DATE EXP.DATE OPERATIONAL TANK TANK CONT NT MAJO 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 - - PIPING19 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 - UNAUTHORIZED RELEASES REPORTED 33 34 - _ - --" -- SAFETY HAZARD35 36 CONDITIONS ABATED 37 " TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 38 39 - FLAMMABLE VAPORS REMOVED 40 ACCESS LOCATIONS SEALED 41 42 POWER DISCONNECTED 43 - OWNER/OPERATOR MONITORING 44 45 PERMANENT TANK CLOSURE REMOVAL OF RESIDUAL MATERIALS 46 47 PIPING 48 49 - FLAMMABLE VAPORS REMOVED 50 UNAUTHORIZED RELEASE 51 52 SAMPLING 53 54 PROPER ABANDONMENT 55 56 THE MARKED ITIS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: 58 59 MAJOR ISI MINOR .NO VIOL. VIOL. 0 VIOL.El_ - i OFFICE: INSP: RECEIVED BY: TITLE: PHONE: K: HUT-3 ORIGINAL 5/w ©,