Laserfiche WebLink
UNDERGROUNIE --ANK PROGRAM OFFICIAL INSPEr-ION REPORT <br /> ,4wAN JOAQUIN HEALTH DISTRICT -NI( <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME �"� STOCKTON, CA 95205 COUNTY #,j <br /> (,v�v PHONE NO. 468-3423 <br /> SITE NAME: INSPECTION DATE: g' <br /> SITE ADDRESS: QU�.� / CITY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? S NO TANKn TANK TANK O/ TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTERO1 COMPUTER Z- COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYP FINSPECTION SITE COMPUTER# <br /> 7 PER# PER# PER# PER# <br /> EXP.DATE- EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR I 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 38 139 <br /> FLAMMABLE VAPORS REMOVED W43 <br /> ACCESS LOCATIONS SEALED POWER DISCONNECTED OWNER/OPERATOR MONITORING <br /> 7 <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: 0i- <br /> MAJOR 57 MINOR 58 NO 59 <br /> VIOL E] VIOL. ❑ VIOL WJ <br /> OFFICE- INSP: R EIVED BY: <br /> TITLE: �J�y S' 7 ONE RECK <br /> HUT-3 /� ORIGINAL 0" <br />