Laserfiche WebLink
UNDERGROUN&TANK PROGRAM OFFICIAL INSP TION REPORT <br /> ;AN 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: <br /> SITE ADDRESS: 1 Cq/ e (9CITY/STATE/ZIP SNC <br /> CHANGES SITE/OWNER/PERMIT? YES ff NO TANK TANK TANK TAHK <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 /> Ko !'i Z 3y9- EXP.DATE FXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL 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 13 14 <br /> MONITORING RECORDS MAINTAINED 15 1 <br /> ACCESS CASING SECURED 17 18 <br /> PIPING 19 20 <br /> INVENTORY RECONCILIATION 21 22 v <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 135 36 <br /> CONDITIONS ABATED VZ37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED 40 ME <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED mil—] <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 51 527 _ <br /> SAMPLING 53 <br /> IMPROPER ABANDONMENT 55 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK(ONE) FOLLOWS: <br /> MAJOR 57 59 <br /> MINOR 58 NO <br /> VIOL. ❑ VIOL. VIOL.❑ _ _ __ <br /> OFFICE: INSP-r, U�� rx RECEIVED B . <br /> TITLE: PHONE: BECK: <br /> HUT-3 ORIGINAL 15 as <br />