Laserfiche WebLink
UNDERGROU TANK PROGRAM OFFICIAL INSP jfION REPORT <br /> AN JOAQUIN HEALTH DISTRICT <br /> .�@6-:-c-,-„tZELTOId,-AVE. <br /> q� &TeG*T9N QA-e&2eb COUNTY # <br /> COUNTY NAME n`J �rle�-sae-uee=s�3- <br /> y INSPECTION DATE:5-Z."2- <br /> SITE NAME: V Half- J <br /> SITE ADDRESS: 2CP V Ml 1 lab/o �fTANKh CITY/STATE/ZIP�e�- CX- 95z23 <br /> TANK <br /> CHANGES SITE/OWNER/PERMIT? YES NO COMPUTER d COMPUTER TANTANd2 COMPUTER O3 COMPUTER <br /> FORM A AND/OR B SUBMITTED? NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER# PER# PER# PER# <br /> EXP.DATEEXP.DATE EXP.DATE EXP.DATE <br /> TANK CONTENTS <br /> OPERATIONAL TANK MAJOR MINOR <br /> PERMIT TO OPERATE 1 2 <br /> CHANGE IN CONDITIONS TO OPERATE. 3 4 _ <br /> APPROVED CONSTRUCTION 5 6 -- <br /> WRITTEN MONITORING PROCEDURES 7 8 - <br /> APPROVED MONITORING SYSTEM 9 10 <br /> MONITORING SYSTEM 11 12 ---_ <br /> APPROVED MONITOR FREQUENCY 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 -- <br /> ACCESS CASING SECURED 17 18 <br /> PIPING 19 20 - <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 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 39 -" <br /> FLAMMABLE VAPORS REMOVED 40 - -- - <br /> ACCESS LOCATIONS SEALED 41 42 --.- .- - - -- "--- <br /> POWER DISCONNECTED 43 <br /> ----- -- <br /> OWNER/OPERATOR MONITORING 44 45 <br /> PERMANENT TANK CLOSURE � w�,. =:.,„ . •- <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 __---- <br /> - _----..._..__-.------- <br /> PIPING 48 49 -- ___- <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 53 54 <br /> IMPROPER ABANDONMENT 155 V 156 " <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEMSTATU/ (MUST MARK ONE) FOLLOWS: <br /> 7SOU C13Y1n(�2TZ�n� 7 <br /> ffi'/1 MINORNO <br /> VIOL VOL.ElVIOL IJ VIOL <br /> OFFICE: INSP: lQ RECEIVED B� <br /> TITLE: K j,. ,�' PHONE: - BECK: <br /> HUT=3 ORIGINAL <br />