Laserfiche WebLink
UNDERGROUISTANK PROGRAM OFFICIAL INSP TION REPORT <br /> SAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME sToc TON, CA 95205 COUNTY # q <br /> t^{�, �QQ 1 PHONE NO. 468-3423 / q <br /> SITE NAME: 1 Id , V C <br /> Tp, G INSPECTION DATE: <br /> 11 <br /> SITE ADDRESS: 5 D '7 �' 1 CITY/STATE/ZIP �' fb Ion <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK p TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF I S`P^ECCTION SITE COMPUTER# PER# PER# PER# PER# <br /> r a+ ' :z 0 1 cR D EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPE A OVAL 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 11 12 _. _ <br /> APPROVED MONITOR FREQUENCY � <br /> 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 30 <br /> APPROVED TANK REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD35 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 138 39 <br /> FLAMMABLE VAPORS REMOVED W4445 <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 1/ ✓ <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: -.2— <br /> 58 59 <br /> MAJOR 'S7 MINOR NO <br /> VIOL. VIOL .VIOL <br /> El <br /> OFFICE: INSP: CA--) RECEIVED BY: <br /> 114 TO e <br /> TITLE: PHONE: RECK: <br /> HUT-3 ' y ORIGINAL Slee O, <br />