COMPLIANCE INFO 1989-1994 - Laserfiche WebLink

Home Browse Search

UNDERGROIo TANK PROGRAM OFFICIAL INSWTION REPORT SAN JOAQUIN HEALTH DISTRICT COUNTY NAME 1601 E. HAZELTON AVE. STOCKTON, CA 95205 PHONE SITE NAME: NO. 466-3423 COUNTY # _/ SITE ADDRESINSPECTION DATE: S: 7� CITY/STATE/ZIP�J CHANGES SITE/OWNER/ ERMIT? YES NO TANK FORM A AND/OR B SUBMITTED? o TANK e TANK TYPE OF INSPECTION COMPUTER COMPUTER COMPUTER SITE COMPUTER# NUMBER NUMBER NUMBER COMPUTER �J�'7 PER# PER# NUMBER PER# PER# OPERATIONAL TANKEXP.DATE EXP DATE TaNKcoNreNrs EXP.DATE EXP.DATE PERMIT TO OPERATE MAJOR MINOR ` CHANGE IN CONDITIONS TO OPERATE 1 2 3 4 APPROVED CONSTRUCTION 5 6 -- WRITTEN MONITORING PROCEDURES __ --- --'-_- - APPROVED MONITORING SYSTEM 7 8 9 10 MONITORING SYSTEM - -- APPROVED MONITOR FREQUENCY 11 12 MONITORING RECORDS MAINTAINED 13 14 ACCESS CASING SECURED 15 16 - --- PIPING 17 18 INVENTORY RECONCILIATION 1921 22 20 _... TANK GAUGING 23 24 _- -- APPROVED RESPONSE PLAN P8 --_ _ - - -- 26 UNAUTHORIZED RELEASE OCCURRENCE 27 28 - SAMPLING APPROVED TANK REPAIRS 29 30 31 32 UNAUTHORIZED RELEASES REPORTED 33 34 - -- ` SAFETY HAZARD i - -"----- 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 44 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 ABANDONMENT 55 56 THE MARKED ITEMS REPRESENTV SYSTEM STATUS(MUST MARK ONE) I LATIONS AND MUST BE CORRECTED AS FOLLOWS: %xcx 57 58 MAJOR MINOR NO 59 VIOL VIOL ❑ VIOL❑ OFFICE: RECEIVED BY: TITLE: PHONE: RECK: IUT-3 d8- 0 333 ORIGINAL siae OM