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UNDERGROUIO ANNK PROD RAM N HEALTH I AL STRICTI&ION REPORT <br /> 1601 E. HAZELTON AVE. <br /> STOCKTON, CA 95205 COUNTY # <br /> COUNTY NAME PHONE NO. 468-3423 <br /> SITE NAME: INSPECTION DATE: <br /> /lyl 44'' <br /> SITE ADDRESS: /1 CITY/STATE/ZIP <br /> CHANGES SITE YES NO TANK wJ�L J� TANK TANK TANK <br /> FORM AAND/OR BSUBMITTED7 COMPUTER / COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF JINSPECTION U�/ SITE COMPUTEE.R�# PER# PER# PER# PER# <br /> �'E- EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> TANK NOR <br /> OPERATIONA TANK <br /> MAAJORJAR 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 <br /> APPROVED TANK REPAIRS 31 <br /> UNAUTHORIZED RELEASES REPORTED 33 -- <br /> SAFETY HAZARD 35 <br /> CONDITIONS ABATED - 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 39 -. - <br /> FLAMMABLE VAPORS REMOVED 40 .-.--.---.----- - <br /> ACCESS LOCATIONS SEALED 41 42 -_-__.-_._....-.. <br /> POWER DISCONNECTED 43 - - - <br /> OWNER/OPERATOR MONITORING 44 45 <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 155 156 <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. ❑ VIOL ❑ VIOL. <br /> OFFICE: 5NSP: RECEIVED BY: <br /> E PHONE: BECK: <br /> A <br /> HUT-3 ORIGINAL <br />