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UNDERGROUWTANK PROGRAM OFFICIAL INSP�TION REPORT <br /> AN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME_�� STOCKTON, CA 95205 COUNTY #� <br /> PHONE NO. 468-3423 <br /> SITE NAME: ` INSPECTION DATE: <br /> SITE ADDRESS: /O �{Jg E C $ CITY/STATE/ZIP ( G (/ CA 9� <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANKTANK vTANK 3 TVY` TANK <br /> FORM A AND/OR B SUBMITTED? COMPU ER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER# PER# PER# PER# <br /> I" D CC` h--e- 1?"5 o EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONT NT <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 9 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 /> PIPING 19 20 <br /> INVENTORY RECONCILIATION 21 22 <br /> V .... V .. ._._ <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 135 136 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL W43 <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED <br /> POWER DISCONNECTED OWNER/OPERATOR MONITORING <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 49 <br /> FLAMMABLE VAPORS REMOVED 50 mm <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 53 54 <br /> IMPROPER ABANDONMENT 55 56 .V/ <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> 58 59 <br /> MAJOR 57 <br /> l/ MINOR NO <br /> VIOL. ISd VIOL. VIOL. <br /> OFFICE: INSP: , y� RECEIVED <br /> TITLE: 'R E� ' S PHONE: BECK: <br /> HUT-3 ORIGINAL 5/88 © <br />