COMPLIANCE INFO 1995-2006 - Laserfiche WebLink

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UNDERGROU ANK PROGRAM OFFICIAL INSP ION REPORT AN JOAQUIN HEALTH DISTRICT 1601 E. HAZLETON AVE. COUNTY NAME P ONE NO. 4 8OCKTON, CA 93423 COUNTY # SITE NAME: ! r INSPECTION DATE:iI ?, --13 SITE SITE ADDRESS: 6 3 �+ I I L CITY/STATE/ZIP /,� !q f37A CHANGES SITE YES NO TAN TA K TANK TANK FORM A AND/OR B SUBMITTED? coMPUTER COMPUTERS//' COMPUTER COMPUTER TYPE OF INSPECTION SITE COMPUTER# NUMBER /�] UMBER pC NUMBER NUMBER �f PER # r _v _ PER# /n ) R # PER # k ✓ EXP. DATE/DO O DATE'S 60C) e EXP.DATE EXP.DATE OPERATIONAL TANK TANK CONTENTS MAJOR MINOR PERMIT TO OPERATE 1 2 CHANGE IN CONDITIONS TO OPERATE 3 4 ----__--- '— APPROVED CONSTRUCTION 5 6 - - - -- WRITTEN MONITORING PROCEDURES 7 8 - 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 21 22 "- -- -- TANK GAUGING23 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 ABATED37 "--""- "- TEMPORARY TANK CLOSURE I REMOVAL OF RESIDUAL 38 39 FLAMMABLE VAPORS REMOVED 40 ACCESS LOCATIONS SEALED- 41 42 POWER DISCONNECTED 43 -- - - OWNER/OPERATOR MONITORING 44 45 -------PERMANENTTANKTANK CLOSURE REMOVAL OF RESIDUAL MATERIALS 46 47 --- - - -"----"" ---- ---_-_— - PIPING 48 49 - - ' FLAMMABLE VAPORS REMOVED 50 _--'- --- -- --------- UNAUTHORIZED RELEASE51 52 ------ SAMPLING 53 54 -------- IMPROPER ABANDONMENT 55 - -.._..._._._.. THE MARKED MS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: NIAJOR 57 MINOR 58 NO 59 VIOL. ❑ VIOL. ❑ VIOL. OFFICE: INSP RECEIVED BY: 6 TITLE: i��ij PHONE, �i !"' D / R CK: i HUT-3 ORIGINAL siae