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UNDERGROUTANK PROGRAM OFFICIAL INSPTION REPORT <br /> *SAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE <br /> - <br /> COUNTY NAME,5a,,4 STOCKTON, CA PHONE NO, 468 3443 COUNTY # <br /> SITE NAME: ]�� f po S / INSPECTION DATE: <br /> SITE ADDRESS: �� CITY/STATE/ZIP 's L �' <br /> CHANCES SITE/OWNER/PERMIT? YES NO TANK TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER <br /> { , W V G_ n r PER # PER# PER# PER# <br /> �� ( EXP DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR MIiVOR <br /> PERMIT TO OPERATE 1 2 <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 _ <br /> APPROVED CONSTRUCTION 5 6 <br /> _ - <br /> WRITTEN MONITORING PROCEDURES 7 8 _ <br /> APPROVED MONITORING SYSTEM 9 10 <br /> MONITORING SYSTEM ill 112 <br /> APPROVED MONITOR FREQUENCY 13 14 <br /> --. <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ACCESS CASING SECURED 17 18 9� <br /> PIPING 19 20 <br /> �NVENTORY 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 35 136 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 139 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 <br /> OWNER/OPERATOR MONITORING 44 45 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 1 . <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 52 � <br /> SAMPLING 53 54 <br /> IMPROPER ABANDONMENT 55 156 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS A D M ST BE CORRE TED AS <br /> SYSTEM STATUS(MUST MARK ONE) <br /> FOLLOWSQ <br /> 58 <br /> - t <br /> MAJOR 57 MINOR NO 0 <br /> VIOL. VIOL. VIOL. <br /> a'c <br /> OFFICE: INSP: RECEIVED BY: y ' <br /> TITLE: PHONE_ RECK: <br /> HUT-3 DRIGI�AL sass Om <br />