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UNDERGROL=sem ` TANK PROGRAM OFF 1L. <br /> REPORT <br /> 3AN JOAQUIN HEALTH DISTRIC <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME�� STOCKTON, CA 95205 COUNTY # <br /> PHONE NO. 468-3423 ? �[ <br /> II <br /> SITE NAME: INSPECTION DATE: <br /> SITE ADDRESS: ' a I CITY/STATE/ZIP Lkq7{ (. <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK 0/ TANK,), d ;L . TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER' <br /> TYPE OF`INSPECTION <br /> �f� SITE COMPUTER# PER# PER#'I € PER# PER # � <br /> D 7 EXP.DATE" EXP.DATE I! EXP.DATE EXP.DATE f <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR MINOR t, " a ^ <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 k <br /> MONITORING SYSTEM 11 112 <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 j <br /> TANK GAUGING 23 124 <br /> APPROVED RESPONSE PLAN 25 26 <j4Ud <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 28 <br /> SAMPLING 29 30 h ` 11 <br /> APPROVED TANK REPAIRS 31 32 I <br /> UNAUTHORIZED RELEASES REPORTED 33 134 s <br /> SAFETY HAZARD 35 136 <br /> CONDITIONS 0 5 A A <br /> B TED F, 37ilY <br /> l <br /> E it <br /> TEMPORARY TANK CLOSUREON <br /> S � <br /> REMOVAL OF RESIDUAL 38 39 t <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 le f <br /> OWNER/OPERATOR MONITORING 144 145 1 #} <br /> PERMANENT TANK CLOSURE � � qWE- <br /> � ' <br /> 43 <br /> � r w <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 49 I <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 52 i � e <br /> SAMPLING 53 i54 r.I <br />' IMPROPER ABANDONMENT 55 56 <br /> THE MARKED ITEMS.REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM!STATUS{MUST tvlAfllC ONE} <br /> -:1 <br /> FOLLOWS: <br /> MAJOR 57 MINOR 58 NO 59 <br /> VIOL. ❑❑ VIOL. VIOL❑ <br /># P <br /> s .I <br /> OFFICE: INSP: RECEIVED BY: <br /> 5 'I <br /> TITLE: c PHONE: PECK_ <br /> HUT-3 ORIGINAL II sras OM <br />