Laserfiche WebLink
• UNDERGROUND T# PROGRAM OFFICIAL INS*ION RUM <br /> COUNTY NAMZ <br /> SITE NAME INSP DATE: <br /> SITE ADDRESS C/S/Z <br /> CHANGES SITE/OWNER/OPER ? TANK TANK TANK TANK <br /> YES NO M.F.R. SUBMIT. ID # to 0 W 0 too <br /> �I � ,�- p� � PER r <br /> SITS COMP. M TYPE OF IN3P PER 1 f s � E, DATt EXP DATE <br /> �L �c.c'7s- f <br /> OrnATIONAL VIOEAI?IM 7777177 <br /> 1. Permit to Operate <br /> 2. Change in Cond. to Operate <br /> 3. Approved Construction <br /> 4. Britten Monitoring Procedures <br /> 5. Approved Monitoring System <br /> 6. Monitoring System Operational <br /> 7. Approved Monitoring Frequency <br /> 8. Monitoring Records Keiatained <br /> 9. Access Casing Secured <br /> 10. Piping <br /> 11. Inventory Reconciliation <br /> 12. Tank Guaging <br /> 13. Approved Response Plan <br /> 14. Unauthorized Release Occurrence <br /> 15. Sampling <br /> 16. Approved Tank Repairs <br /> 17. Unauthorized Releases Reported <br /> 16 Safety Hazard <br /> 19. Conditions Abated <br /> TEMPOPARY CLOSURE <br /> 20. Removal of Residual Materials 77771717 111 /1117-77 <br /> 21. Flan.aable Vapors Removed <br /> 22. Access Locations Sealed 5 <br /> 23. Power Disconnected <br /> 24. Owner/Operator Monitoring <br /> PQVVJCtr CIA6ORE <br /> 25. Removal of Residual Materials <br /> 26. Piping <br /> 27. Flammable Vapors Removed <br /> 28. Unauthorized Releane <br /> 29 Sampling <br /> 30. Improper Abandonment <br /> Time marked Items represent violations end mwust be corrrctod as follows: <br /> t <br /> E or•r Ice: IkSP: RECEIVED BY: <br /> PHOKE i T1 <br />