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AL UNDERGROU16 AN PROD RAM N HEALTH I STRIC�TION REPORT 1601 E. HAZELTON AVE- COUNTY # 9 ,� STOCKTON, CA 95205 COUNTY NAME SO rA f0 PHONE NO. 468-3423 INSPECTION DATE.12-5- 9a SITE NAME: (3(fC4c_or) 7* 1 �� CITY/STATE/ZIP s4&cA: vA 1 9SL SITE ADDRESS: 3 TANK TANK TANK TANK CHANGES SITE/OWNER/PERMIT? YES NO COMPUTER COMPUTER COMPUTER CUMBER FORM A AND/OR B SUBMITTED? NUMBER NUMBER NUMBER PER# PER# PER # TYPE OF INSPECTION SITE COMPUTER# PER# EXP.DATE •^ 11-73 EXP.DATE EXP.DATE EXP.DATE I J TANK CONTENTS OPERATIONAL TANK MAJOR PERMIT TO OPERATE a — CHANGE IN CONDITIONS TO OPERATE 3 ..__ APPROVED CONSTRUCTION 5 ----- _ _ WRITTEN MONITORING PROCEDURES 7 8 '- APPROVED MONITORING SYSTEM 9 10 -- MONITORING SYSTEM 11 12 APPROVED MONITOR FREQUENCY 13 14 - MONITORING RECORDS MAINTAINED 15 16 'r - ACCESS CASING SECURED 17 18 . PIPING 19 20 22 -- _. - ._. INVENTORY RECONCILIATION 21 _- TANK GAUGING 23 24 --- - - APPROVED RESPONSE PLAN 25 26 - - UNAUTHORIZED RELEASE OCCURRENCE 27 28 --- SAMPLING 29 30 APPROVED TANK REPAIRS 31 32 - - - UNAUTHORIZED RELEASES REPORTED 33 34 SAFETY HAZARD 35 36 _ CONDITIONS ABATED 37 TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 38 39 -- FLAMMABLE VAPORS REMOVED 40 - ACCESSLOCATIONSSEALED 41 42 _.. -- POWER DISCONNECTED 43 OWNER/OPERATOR MONITORING 44 45 PERMANENT TANK CLOSURE 7 .. . ._..._-- ... REMOVAL OF RESIDUAL MATERIALS 46 4 ._---------- ,. _ ... . _. .. PIPING 48 49 ------------ 50 - FLAMMABLE VAPORS REMOVED UNAUTHORIZED RELEASE 51 52 -.- - SAMPLING 53 54 -- - - IMPROPER ABANDONMENT 55 56 THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: SC C 57 58 59 MAJOR ❑ MINOR NO VIOL. VIOL. VIOL.❑ /Y1C(,l 'f'fl OFFICE: INSP: TCUie Ctiktwe�� U irYlelr-A- Pa-/' ' PHONE: RECK: cis J-5u TITLE: r,N.S siae HUT-3 ORIGINAL.