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UNDERGROU"O TANK PROGRAM OFFICIAL INS; -CTION REPORT <br />y SAN JOAQUIN HEALTH DISTRICmw <br />1601 E. HAZELTON AVE. <br />COUNTY NAME STOCKTON, CA 95205 COUNTY # <br />PHONE NO. 468-3423 <br />ISITE NAME: �F-5 i' Pvi_/GT'i./% INSPECTION DATE://7/`1r5 I <br />ADDRESS: ?O0 yL Y-2�7251-lla /ewz� CITY/STATE/ZIP lid <br />IGES SITE /OWNER/ PERMIT? YES NO I TANK -al TANK Z ITAN <br />A AND/OR B SUBMITTED? <br />Aov-n,pe;V/5 1 17 <br />OPERATIONAL TANK <br />PERMIT TO OPERATE <br />CHANGE IN CONDITIONS TO OPERATE <br />APPROVED CONSTRUCTION <br />WRITTEN MONITORING PROCEDURES <br />APPROVED MONITORING SYSTEM <br />MONITORING SYSTEM <br />APPROVED MONITOR FREQUENCY <br />MONITORING RECORDS MAINTAINED <br />ACCESS CASING SECURED <br />PIPING <br />INVENTORY RECONCIUATION <br />TANK GAUGING <br />APPROVED RESPONSE PLAN <br />UNAUTHORIZED RELEASE OCCURRENCE <br />SAMPLING <br />APPROVED TANK REPAIRS <br />UNAUTHORIZED RELEASES REPORTED <br />SAFETY HAZARD <br />CONDITIONS ABATED <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL <br />FLAMMABLE VAPORS REMOVED <br />ACCESS LOCATIONS SEALED <br />POWER DISCONNECTED <br />OWNER/OPERATOR MONITORING <br />PERMANENT TANK CLOSURE <br />REMOVAL OF RESIDUAL MATERIALS <br />PIPING <br />FLAMMABLE VAPORS REMOVED <br />UNAUTHORIZED RELEASE <br />SAMPLING <br />IMPROPER ABANDONMENT <br />(MUST MARK <br />COMPUTER COMPUTER COMPUTER <br />NUMBER IZ;: NUMBER poi my NUMBER <br />R # PER # 4 r.�L. PER # 'P L PER # ✓�L <br />EXP. DATE EXP. DATE EXP. DATE <br />TANK CONTENTS <br />1 <br />3 <br />5 <br />7 <br />9 <br />11 <br />13 <br />15 <br />17 <br />19 <br />21 <br />23 <br />25 <br />In <br />In <br />In <br />In <br />Im <br />Im <br />Im <br />Im <br />Im <br />Im <br />Im <br />Im <br />Im <br />Im <br />Im <br />I® <br />Im <br />1m <br />M111111110 <br />�m <br />■ <br />E <br />®m <br />®M <br />®m <br />58 59 <br />MAJOR 57 MINOR - NO <br />VIOL. 0 VIOL. 1:1VIOL. <br />TANK Af N <br />COMPUTER <br />NUMBER /, 006 <br />PER # 4011b <br />THE MARKED ITEMS REPRESENT NTQVIIOOLLATIONS AND MUST BE CORRECTED AS <br />FOLLOWS: ;W i`�'__'T <br />INSP:RECEIVED BY:,-e--AT�T0: /?O. P50X/27o <br />' a/o T61�,o T <br />TITLE: �.L'• J " �' PHONEo^ BECK: <br />HUT -3 ORIGINAL <br />