Laserfiche WebLink
UNDERGROU$TANK PROGRAM OFFICIAL INSPOION REPORT <br />SAN JOAQUIN HEALTH DISTRICT <br />1601 E. HAZELTON AVE. - <br />STOCKTON, CA 95205 COUNTY #` j <br />PAIINTY NAMF lrw ., 4n4is Ci a i . 'ounklC kin nan_zaoa <br />SITE NAME: i� "'4) <br />HUT -3 <br />FILE COPY <br />INSPECTION DATE: <br />SITE ADDRESS: /�/�� J <br />J�� <br />GC/C <br />CITY/STATE/ZIP <br />CHANGES SITE/OWNER/PERMIT? <br />YES <br />NO <br />TANK O 1 <br />TANK- <br />TANK <br />TANK <br />FORM A AND/OR B SUBMITTED? <br />COMPUTER <br />NUMBER <br />PER # <br />COMPUTER <br />NUMBER <br />PER # <br />COMPUTER <br />NUMBER <br />PER # <br />COMPUTER <br />NUMBER <br />PER # <br />TYPE OF INSPECTION� q <br />SITE COMPUTER f,# <br />EXP. DATE <br />EXP. DATE <br />EXP. DATE <br />EXP. DATE <br />OPERATIONAL TANK <br />TANK CONTENTS 1 <br />MAJOR MINOR <br />PERMIT TO OPERATE <br />CHANGE IN CONDITIONS TO OPERATE <br />1 <br />3 <br />2 <br />4 <br />APPROVED CONSTRUCTION <br />5 <br />6 <br />WRITTEN MONITORING PROCEDURES <br />7 <br />8 <br />-. <br />APPROVED MONITORING SYSTEM <br />9 <br />10 <br />_.. <br />MONITORING SYSTEM <br />11 <br />12 <br />_. <br />APPROVED MONITOR FREQUENCY <br />MONITORING RECORDS MAINTAINED <br />13 <br />15 <br />14 <br />16 <br />- <br />ACCESS CASING SECURED <br />17 <br />18 <br />PIPING <br />19 <br />20 <br />INVENTORY RECONCILIATION <br />21 <br />22 <br />TANK GAUGING <br />23 <br />24 <br />APPROVED RESPONSE PLAN <br />25 <br />26 <br />UNAUTHORIZED RELEASE OCCURRENCE <br />` <br />... <br />SAMPLING <br />APPROVED TANK REPAIRS <br />K37 <br />UNAUTHORIZED RELEASES REPORTED <br />SAFETY HAZARD <br />CONDITIONS ABATED <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL <br />9 <br />FLAMMABLE VAPORS REMOVED <br />ACCESS LOCATIONS SEALED <br />W43 <br />2 <br />POWER DISCONNECTED <br />OWNER/OPERATOR MONITORING <br />5 <br />PERMANENT TANK CLOSURE <br />REMOVAL OF RESIDUAL MATERIALS <br />46 <br />47 <br />_. <br />PIPING <br />48 <br />49 <br />FLAMMABLE VAPORS REMOVED <br />50 <br />f <br />UNAUTHORIZED RELEASE <br />51 <br />52 <br />SAMPLING <br />53 <br />54 <br />IMPROPER ABANDONMENT <br />55 <br />56 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />SYSTEM STATUS (MUST MARK ONE)/ <br />FOLLOWS: <br />MAJOR 57 MINOR N NO <br />59 <br />❑ <br />❑ <br />VIOL. VIOL. LL`7� VIOL <br />OFFICE: <br />INSP:^ }pw <br />-' <br />RECEIVED BY: <br />q�pr�u <br />TIT <br />E: e {''" <br />HONE: <br />BECK: <br />HUT -3 <br />FILE COPY <br />