Laserfiche WebLink
UNDERGROUND T'VK PROGRAM OFFICIAL INSPECT''N REPORT i�y d �� Z <br /> S.,A JOAQUIN HEALTH DISTRICT y,p <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY # <br /> PHONE NO. 468-3423 <br /> SITE NAME: .(1J'� S' S INSPECTION DATE:/0— <br /> SITE ADDRESS: CITY/STATE/ZIP 411- 7� <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK I TANK Z/ TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMP U COMPUTER COMPUTE <br /> TYPE F INSP GTION SITE COMPUTER# NUMBER NUMBETr Y NUMBE7V07V , NUMBE <br /> PER#1rj/b0o / PER# /� PER# ,/ /�`D � PER# <br /> N /v'C v / EXP.DATE EXP.DATE EXP.DAT- .DA <br /> OPERATIONAL TANK TANK CON NT <br /> 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 P43 <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED <br /> 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 <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 53 54 <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> MAJOR 57 MINOR 58 NO 59 <br /> VIOL. ❑ VIOL. ❑ VIOL. <br /> OFFICE: INSP: ECEIV BY: <br /> TITLE: � PHONE: BECK: <br /> HUT-3 ORIGINAL 5 ae �' <br />