Laserfiche WebLink
UNDERGROU TANK PROGRAM OFFICIAL INSP ION REPORT <br /> WSAN JOAOUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> STOCKTON, CA 95205 COUNTY # <br /> COUNTY NAME PHONE NO. 468-3423 <br /> INSPECTION DATE: <br /> SITE NAME: PL b7 �i <br /> SITE ADDRESS: ITY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? YES O TANK TANK / TANK TANK <br /> COMPUTER COMPUTER COMPUTER COMPUTER <br /> FORM A AND/OR B SUBMITTED? NUMBER /70 NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPU R# PER # PER# U1?/fa,i: PER# PER# <br /> EXP.DATE EXP.DATE /�'l%C 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 22TANK GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 25 26 --- <br /> UNAUTHORIZLD RELEASE OCCURRENCE 27 28 - -- <br /> SAMPLING 29 30 <br /> APPROVED TANK REPAIRS 31 --- <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 - <br /> OWNER/OPERATOR MONITORING 44 `15 <br /> PERMANENT TANK CLOSURE ��- • +'`J .„ <br /> 6{ <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 49 - ---"-----. <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 52 -" ----- "'- <br /> SAMPLING 53 54 _ __ ._.._._ ....._.—._--... <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED Pj <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> MAJOR 57 MINOR NO 59 <br /> VIOL ❑ VIOL LJ VIOL.❑ <br /> OFFICE: INSP: RECEIVED BY: <br /> TIT S_ PHONE: BECK: <br /> !3 sres <br /> HUT-3 ORIGINAL <br />