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UNDERGROU!" TANK PROGRAM OFFICIAL INSPF`T!ON REPORT �, oAN JOAQUIN HEALTH DISTRICT 1601 E. HAZELTON AVE. COUNTY NAME S�Vl o c STOCKTON, CA 95205 COUNTY # PHONE NO. 468-3423 q SITE NAME: n G r Tyl INSPECTION DATE: SITE ADDRESS: j g s E, Ck G(/ CITY/STATE/ZIPS yl/ C/9 �F`<5 20S CHANGES SITE/OWNER/PERMIT? YES NO TANKp / TANK TANK TANK FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER NUMBER NUMBER NUMBER NUMBER TYPE OF INSPECTION ]SITE COMPUTER# PER# PER# PER# PER# rs 5 / EXP.DATE EXP.DATE EXP.DATE EXP.DATE OPERATIONAL TANK TANK CONTENTS MAJOR I MINOR PERMIT TO OPERATE 1 2 CHANGE IN CONDITIONS TO OPERATE 3 4 APPROVED CONSTRUCTION 5 6 WRITTEN MONITORING PROCEDURES 7 8 APPROVED MONITORING SYSTEM 9 10 --- MONITORING SYSTEM 11 12 - APPROVED MONITOR FREQUENCY 13 14 ------"---- re MONITORING RECORDS MAINTAINED 15 16 ACCESS CASING SECURED 17 18 _._. ------ --- --- PIPING 19 20 - INVENTORY RECONCILIATION 21 22 -. ---" -- - ----- - TANK GAUGING 23 24 APPROVED RESPONSE PLAN 25 26 _ UNAUTHORIZED RELEASE OCCURRENCE 27 28 - --- - SAMPLING 29 30 APPROVED TANK REPAIRS 31 32 -----"- -"-- " UNAUTHORIZED RELEASES REPORTED 33 34 ---._-.- - -- - - --- -- SAFETY HAZARD 35 36 CONDITIONS ABATED 37 µ TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 38 39 - ----- -- FLAMMABLE VAPORS REMOVED 40 ACCESS LOCATIONS SEALED 41 42 --. - POWER DISCONNECTED _.. _ . __ ..._. ... _. OWNER/OPERATOR MONITORING 144 45 PERMANENT TANK CLOSURE N REMOVAL OF RESIDUAL MATERIALS 46 147 __ - ------ --- -"--'-- PIPING 148 149 FLAMMABLE VAPORS REMOVED 50 -- UNAUTHORIZED RELEASE 51 52 SAMPLING 53 54 -- -- IMPROPER ABANDONMENT 55 56 -m_-~ - THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: MAJOR 57 MINOR 58 5 NO 9 VIOL. E] MINOR ❑ VIOL. i OFFICE: INSP: ' RECEIVED BY: a TITLE: PHONE: BECK: 5/88 HUT-3 ORIGINAL