Laserfiche WebLink
UNDERGROUPOTANK PROGRAM OFFICIAL INSP+TION REPORT <br />SAN JOAQUIN HEALTH DISTRICT <br />1601 E. HAZELTON AVE. <br />STOCKTON, CA 95205 COUNTY # <br />COUNTY NAME _ .a r. i . PunMF Mn AAR_3497 <br />HUT -3 <br />OWNER'S COPY <br />5/88 UM <br />SITE NAME:���� <br />INSPECTION DATE: % 7 ley <br />SITE ADDRESS: 1 <br />CITY/STATE/ZIPS �� 7 <br />CHANGES SITE/OWNER/PERMIT? YES <br />N <br />fTANKp <br />TANK [�02TANK <br />TANK <br />FORM A AND/OR B SUBMITTED? <br />UTER <br />COMPUTER <br />COMPUTER <br />COMPUTER <br />ER <br />PER # <br />NUMBER <br />PER # <br />NUMBER <br />PER # <br />NUMBER <br />PER # <br />TYPE OF INSPECTION- <br />SITE COMPUTER # <br />nq <br />&1vt- a- 5 <br />v� 35 r <br />EXP DATE <br />EXP. DATE <br />EXP. DATE <br />EXP. DATE <br />K C <br />OPERATIONAL TANK <br />PERMIT TO OPERATE <br />CHANGE IN CONDITIONS TO OPERATE <br />APPROVED CONSTRUCTION <br />E1314 <br />WRITTEN MONITORING PROCEDURES <br />APPROVED MONITORING SYSTEM <br />MONITORING SYSTEM <br />APPROVED MONITOR FREQUENCY <br />_ <br />MONITORING RECORDS MAINTAINED 15 <br />16 <br />ACCESS CASING SECURED 17 <br />18 <br />PIPING 19 <br />20 <br />c <br />,t F <br />INVENTORY RECONCILIATION 21 <br />22 <br />-2 <br />TANK GAUGING 23 <br />24 <br />APPROVED RESPONSE PLAN 25 <br />26 <br />UNAUTHORIZED RELEASE OCCURRENCE 27 <br />28 <br />SAMPLING 29 <br />30 <br />APPROVED TANK REPAIRS 31 <br />32 <br />UNAUTHORIZED RELEASES REPORTED 33 <br />34 <br />SAFETY HAZARD 35 <br />36 <br />-- <br />CONDITIONS ABATED <br />37 <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL <br />FLAMMABLE VAPORS REMOVED <br />ACCESS LOCATIONS SEALED <br />W4142 <br />POWER DISCONNECTED <br />OWNER/OPERATOR MONITORING <br />PERMANENT TANK CLOSURE <br />REMOVAL OF RESIDUAL MATERIALS 46 <br />47 <br />PIPING 48 <br />49 <br />FLAMMABLE VAPORS REMOVED 50 <br />UNAUTHORIZED RELEASE 51 <br />52,--, <br />SAMPLING 53 <br />54 <br />IMPROPER ABANDONMENT 55 <br />56 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />SYSTEM STATUS (MUST MARK ONE) <br />FOLLOWS: <br />58. 59 <br />MAJOR 0 MINOR NO <br />El <br />VIOL VIOLVIOL <br />OFFICE: <br />INSP: p <br />RECEIVED BY: <br />N <br />Gci <br />TITLE: <br />HONE: <br />RECK: <br />HUT -3 <br />OWNER'S COPY <br />5/88 UM <br />