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UNDERGROU TANK PROGRAM OFFICIAL INSP TION REPORT <br /> WSAN JOAQUIN HEALTH DISTRICIW <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY PHONE NO. 468-3423 <br /> SITE NAME: per! f N1 PE TION DATE: <br /> SITE ADDRESS: CITY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK / TANK NK TANK <br /> TA <br /> FORM A AND/OR B SUBMITTED?v!3 COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER <br /> PER# PER# PER# PER# <br /> EXP.DATE- EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJO INOR <br /> PERMIT TO OPERATE lol 2 <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 ---- <br /> APPROVED CONSTRUCTION 5 16 - <br /> WRITTEN MONITORING PROCEDURES 7b7 8 - <br /> APPROVED MONITORING SYSTEM 9 V 10 -- - <br /> _. _. _.. <br /> MONITORING SYSTEM 117 12 <br /> APPROVED MONITOR FREQUENCY 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ----------- <br /> ACCESS CASING SECURED 17 18 - - <br /> PIPING <br /> INVENTORY RECONCILIATION 21 22 <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 35 36 - - <br /> CONDITIONS ABATED 317 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 1 139 <br /> FLAMMABLE VAPORS REMOVED W4445 <br /> ACCESS LOCATIONS SEALED 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 e - - <br /> UNAUTHORIZED RELEASE 51 52 - <br /> SAMPLING 53 - <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: Zde "o <br /> MAJOR MINOR 58 NO 59 - <br /> VIOL. 57 VIOL ❑ VIOL❑ <br /> OFFICE: INSP: Qy RECEIVED BY: <br /> TITLE:6t'v'r/v`7 - lei PHONE: RECK: <br /> 8--? <br /> HUT-3 ORIGINAL 5/88 ©M <br />