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� 2 <br /> UN•GROUND TANK OFFICIAL INSPECTION RE*T <br /> SAN JOAQUIN PUBLIC HEALTH SERVICES X / <br /> ENVIRONMENTAL HEALTH DIVISION J <br /> 445 N.San Joaquin Street <br /> Mailing Address: P.O.Box 388 <br /> COUNTY NAME Stockton,CA 95201-0388 COUNTY # 7q <br /> 468-3420 <br /> SITE NAME: Slee L INSPECTION DATE: ` 2 <br /> SITE ADDRESS: CITY/STATE/ZIP � -- <br /> CHANGES SITE/OWNER/PERMIT? YES / NO TANK TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBEO`✓ NUMBER NUMBER NUMBER <br /> TY OF INSPECTION SITE COMPUTER# PER# PER# PER # PER 0 <br /> EXP.DAT&6 EXP.DATE EXP.DATE EXP DATE <br /> OPERATIONAL TANK TANK CONTeNTs <br /> MAJOR FMINOR <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 19 120 <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 39 <br /> FLAMMABLE VAPORS REMOVED 40 M i <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED M 43 <br /> OWNER/OPERATOR MONITORING 44 45 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 147 <br /> PIPING 48 149 <br /> FLAMMABLE VAPORS REMOVED 50 I <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 53 54 <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED ITEMS REPRESENT VIO ATIONS AND MUST BE CORRECTED A`i <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS:- <br /> 57 <br /> OLLOWS:57 58 59 Il -/2 t i <br /> MAJOR MINOR NO ((�X — — - --- —- — - - - - <br /> VIOL. ❑ VIOL. ❑ VIOL.J1- ,�y <br /> OFFICE: INSP: ri RECEIVED BY: <br /> TITLE /��A � PHONE: RECK: <br /> -633-6 <br /> HUT-3 White-Original Yellow-Owner's Copy Pink-File Copy " <br />