Laserfiche WebLink
UNDERGROUN"`TANK PROGRAM OFFICIAL INSPr_._`UON REPORT <br /> YAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. COUNTY # <br /> -STOCKTON, CA 95205 <br /> COUNTY NAME PHONE NO. 468-3423 <br /> SITE NAME: jj ! �� �� ;� /� S O <br /> INSPECTION DATE: L41-uo/q1 <br /> SITE ADDRESS: (]Q CITY/STATE/ZIP j QC f�TQ ISI C`. <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK <br /> TANK TANK <br /> F FORM AAND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER# PER# PER# PER# <br /> reAle glQ/Q4 q Q EXP.DATE EXP.DATE EXP DATE <br /> U� L EXP.DATE <br />}! - <br /> TANKCONTENTS �° °r+° .._> fir✓ y "`°� r `. ,u­ <br /> 7 . <br /> °,�:' n <br /> OPERATIONAL TANK MAJOR 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 �� u..•. <br /> ACCESS CASING SECURED 17 18 4° <br /> PIPING 19 20 .----- <br /> INVENTORY RECONCILIATION i� 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 33 134 <br /> SAFETY HAZARD 35 136 — <br /> CONDITIONS ABATED 37 <br /> I TEMPORARY TANK CLOSURE 4 <br /> < <br /> < <br /> REMOVAL OF RESIDUAL 38 39 ---- <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED I 43 a <br /> OWNER/OPERATOR MONITORING 44 45 <br /> PERMANENT TANK CLOSURE <br /> 1 92111 <br /> r-h .. :.._ .d <br /> J REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 49 <br /> FLAMMABLE VAPORS REMOVED [53 <br /> _. <br /> UNAUTHORIZED RELEASE 52 <br /> SAMPLING 54IMPROPER ABANDONMENT 56 <br /> 4 THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> ` MAJOR 57 MINOR 58 NO 59 <br /> VIOL. ❑ VIOL. ❑ VIOL.❑ 9 <br /> OFFICE: ' INSP: PNj �.�7 RECEIVED BY: <br /> f <br /> TITLE: 7 r PHONE: BECK: <br /> r <br /> HUT-3 FILE COPY 5isa ©M <br />