Laserfiche WebLink
UNDERGROU• TANK PROGRAM OFFICIAL INS TION REPORT <br />SAN JOAQUIN HEALTH DISTRICT <br />1601 E. HAZELTON AVE. <br />STOCKTON,CA 95205 <br />COUNTY NAME 9 <br />cSG7 , _.f�../i/tiJ PHONE NO. 466-3423 COUNTY#39' <br />SITE NAME: G�i ` <br />�' <br />INSPECTION DATE: <br />SITE ADDRESS: / p/ / eMN <br />S7L <br />CITY/STATE/ZIP / / <br />'0:3 <br />CHANGES SITE/OWNER/PERMIT? YESl <br />NO <br />TANK O / <br />TANK 0.1 <br />TANK <br />TANK 0 <br />FORM A AND/OR B SUBMITTED? <br />COMPUTER <br />COMPUTER <br />COMPUTER <br />COMPUTER <br />NUMBER <br />PER # <br />NUMBER <br />PER # <br />NUMBER <br />PER # <br />NUMBER <br />PER # <br />TYPE <br />I�yNISSPECCT�IONN1 <br />SITE COMPUTER # <br />, ��OF�� <br />✓rvy 1 C(_� <br />EXP. DATE <br />EXP_ DATE <br />EXP. DATE <br />EXP. DATE <br />OPERATIONAL TANK TANK CONTENTS <br />MAJOR MINOR <br />PERMIT TO OPERATE 1 <br />2 <br />CHANGE IN CONDITIONS TO OPERATE 3 <br />4 <br />APPROVED CONSTRUCTION <br />WRITTEN MONITORING PROCEDURES 7 <br />APPROVED MONITORING SYSTEM 9 <br />MONITORING SYSTEM 11 <br />APPROVED MONITOR FREQUENCY 13 <br />F20 <br />MONITORING RECORDS MAINTAINED 15 <br />ACCESS CASING SECURED 17 <br />' <br />PIPING 19 <br />INVENTORY RECONCILIATION 21 <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 />CONDITIONS ABATED <br />37 <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL <br />FLAMMABLE VAPORS REMOVED <br />ACCESS LOCATIONS SEALED <br />W4445 <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 />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 />Q <br />57 8 9 <br />MAJOR MINOR NO <br />LJ <br />- - - <br />VIOL. VIOL VIOL <br />OFFICE: <br />INSP: FGFmI4 <br />Q -EW: <br />a4Ce-w-to , 14 <br />/k16 F, vVic <br />TITLE: <br />ONE: <br />/ K: <br />b <br />HUT -3 ORIG(NAL alae O, <br />