COMPLIANCE INFO 1995-2006 - Laserfiche WebLink

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UNDERGROU TANK PROGRAM OFFICIAL INSP TION REPORT WAN JOAQUIN HEALTH DISTRICT 1601 E. HAZELTON AVE. COUNTY NAME STOCKTON, CA 95205 PHONE NO. 468-3423 COUNTY # SITE NAME: SPECTION DATE: / 3_G%z SITE ADDRESS: Z ✓ �weTY/STATE/ZIP CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK Z TANK TANK FORM A AND/OR B SUBMITTED? COMPUTERM//s COMPUTE�i J! �S COMPUTER COMPUTER TYPE OF INSPECTION SITE COMPUTER# NUMBER (7n' NUMBER P V�'!� NUMBER NUMBER PER# �� I��/' PER# �D rJ� PER # PER # f� EXP DATE FXP.DATE EXP.DATE EXP.DATE OPERATIONAL TANK TAMK CONTENTS MAJOR MINOR PERMIT TO OPERATE 1 2 CHANGE IN CONDITIONS TO OPERATE 3 4 APPROVED CONSTRUCTION 5 6 _ WRITTEN MONITORING PROCEDURES 7 g APPROVED MONITORING SYSTEM ---- -- - 9 10 MONITORING SYSTEM 11 12 APPROVED MONITOR FREQUENCY 13 14 - -- - -- - -- - MONITORING RECORDS MAINTAINED 15 16 -- ACCESS CASING SECURED 17 18 PIPING 19 20 _- INVENTORY RECONCILIATION "- y -- 21 22 _- TANK GAUGING 23 24 -- APPROVED RESPONSE PLAN -- -" - - 25 26 UNAUTHORIZED RELEASE OCCURRENCE 27 28 _ - -- - - - - SAMPLING 29 30 APPROVED TANK REPAIRS - 31 32 UNAUTHORIZED RELEASES REPORTED 33 34 "- -- -- - -- _.. SAFETY HAZARD 35 36 ---- CONDITIONS ABATED 37 - - --" - - - -- --__---.. TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 38 39 FLAMMABLE VAPORS REMOVED 40 - ACCESS LOCATIONS SEALED -`—"- 41 42 POWER DISCONNECTED 43 ----"---_"--- OWNER/OPERATOR MONITORING qq 45 PERMANENT TANK CLOSURE REMOVAL OF RESIDUAL MATERIALS 46 47 PIPING 48 49 - FLAMMABLE VAPORS REMOVED 50 - UNAUTHORIZED RELEASE --- ------ 51 52 SAMPLING '----_ ---._ _.---_� -- 53 54 ---.----.-.._--_ IMPROPER ABANDONMENT55 56 ------ ------- -._ THE MARKED ITEMS REPRESENT SYSVIOLATIONS AND MUST BE CORRECTED AS TEM SATTUS(MUST MARK ONE) FOLD WS: MAJOR 57 MINOR 58 N 59 VIOL. El OL. ElVIOO L OFFICE: INSR RECEIVED BY: _U TITLES i2Gi/fs PHONE: Z�� RECK: 5 HUT-3 ORIGINAL 83 sees 0