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COUNTY NAME <br /> SITE NAME: ✓1/7 INSPECTION DATE: <br /> SITE ADDRESS: CRY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT S NO TANK TANK TANK TANK <br /> MFR/PERMfT SUBMa-TEG <br /> TYPE OF INSPECTION SITE COMPUTER• PER 0 I PER• �0 ID* <br /> PER <br /> EXP,DATE EXP.DATE EOE DATE EXP.DATE <br /> OPEP.Kr#ONAL.TANK MAJ. LAIN. <br /> PERWT 70 OPERME t 2 <br /> CHANGE N OONDMONS TO OPERATE J 4 <br /> APPROVED CONSTRUCTION N 6 8 <br /> WRITTEN MONITORING PROCEDURES A) 77 <br /> APPROVED MONITORING SYSTEM E 11 10 <br /> MONIIORNG SYSTEM OFERATICNAL-E 11 72 <br /> APPROVED MONITOR FREQUENCY N 13 14 <br /> MONITORING REOOROS MAM'7TAINED E 15 J2O <br /> ACCESS CASING SECUREDN 17 PIPING 1B <br /> INVENTORY RECONCILIATION E 21' 22 <br /> TANK GAUGING E 2324 <br /> APPROVED RESPONSE PLAN At25 26 <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 28 <br /> SAMPLING 291 <br /> APPROVED TAM(REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED JJ 34 <br /> SAFETY HAZARD 351 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38, J9 <br /> FLAMMABLE wPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41! 42 <br /> POWER 04SCONNECTED <br /> OWNER/OPERATOR MONITORING 44. 45i <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 461 47 <br /> PIPING 4I 49i <br /> FLAMMABLE VAPORS REMOVED 50 <br /> 1 gm <br /> UNAUTHORIZED RELEASE "1 52 <br /> SAMPLING SJ 54 <br /> IMPROPER ABANOONMENT 5556 <br /> TIE MARKED ITEMS REPRESENT <br /> T VIOLLA/TIIONS At40 MUST BE CORRECTED AS <br /> SYSTEM STATUS IMNST MARK ONEI FOLLOWSi('Z. di-[ 1 V'tf�Ct�il <br /> _ 57 _ 58 59 <br /> VIOL_ ❑ VIOL ❑ VOL <br /> S RMQUN LOCAL HEALTH DISIRI NSP 9 <br /> RECEIVED BY: <br /> POST OFFICE! BOX 2009 <br /> STOCKTON. CALIF, 95201 U/ <br /> V-TN: ENVIRON. HEALTH TITLE: � PHONE: _ RECK- <br /> ''L riNi.T O- <br />