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UNDERGROUWTANK PROGRAM OFFICIAL INSP�TION REPORT <br /> AN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME.Sg -pQ STOP OCKTON, CA 95205 E N0. 468 3423 COUNTY #,3 9 <br /> SITE NAME: �d �J,,.�, Q INSPECTION DATE: 1-�-93 <br /> SITE ADDRESS: 8"a77 <br /> ` "�I Y�� CITY/STATE/ZIP <br /> CHANGES SITE/OWvNER//PERMIT? YES NO ANK I TANK TANK ? TANK <br /> FORM AAND/OR B SUBMITTED? COMPUTER COMPUTER COM R COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER <br /> a PER# PER# PER# PER# <br /> CTL4'� -I EXP.DATE EXP.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 g 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 /> ._ <br /> PIPING 19 20 _... <br /> INVENTORY RECONCILIATION 21 k2 "- <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 _. ..... _ _... _._..... <br /> 35 36 <br /> CONDITIONS ABATED 37 <br /> —.. <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 55 56 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> FOLLOWS: <br /> SYSTEM STATUS(MUST MARK 5O8NE) <br /> 59 <br /> MAJOR E] MINOR ry NO <br /> VIOL. VIOL. LJ VIOL. <br /> OFFICE: INSP: 100 o <br /> O� Mr, 13oK; des t �frolew4,--T i c, <br /> TITLE: Jit f S PH BECK: <br /> �-- Ria o <br /> HUT-3 ORIGINAL <br />