REMOVAL REMOVAL 1991 - Laserfiche WebLink

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UNDERGROUNNK PROGRAM OFFICIAL INSPE JON REPORT *AN JOACQUIN HEALTH DISTRICT 1601 E. HAZELTON AVE. COUNTY NAME 1 STOCKTON, CA 95205 COUNTY # 59 } �JQ y�l PHONE NO, 468-3423 SITE NAME: INSPECTION DATE: SITE ADDRESS: `L� /� o� � r �/Z / CITY/STATE/ZIP Ai � A CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TA K ANK FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER C MPUTER COMPUTER NUMBER NUMBER UMBER NUMBER TY E OF INSPECTION SITsE GOMPUTER# PER # PER# PER# PER # 2�'r oV EXP.DATE EXP.DATE 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 s_. MONITORING RECORDS MAINTAINED 15 16 ACCESS CASING SECURED 17 118 M. -- PIPING 19 120 INVENTORY RECONCILIATION 21 22 TANK GANGING 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 3 TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 38 39 --- - --- FLAMMABLE VAPORS REMOVED 40mm - ACCESS LOCATIONS SEALED 41 42 -- --- POWER DISCONNECTED m 43 - OWNER/OPERATOR MONITORING 44 45 ERMANENT TA K CLOSURE R AL OF RESIDUAL MAT 46 47 _ --- PIPING 48 49 , FLAMMABLE VAPORS REMOVED 50 �— UNAUTHORIZED RELEASE 51 52 SAMPLING 53 54 IMPROPER ABANDONMENT 55 56 THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE COR ECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: MAJOR 57 MINOR 58 NO 9 VIOL. ❑ VIOL. ❑ VIOL.- OFFICE: 1,y RECEIVED BY: TITLE: PHONE: RECK: 5/as Om HUT-3 ORIGINAL