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UNDERGROUN.igANK PROGRAM OFFICIAL INSPE TION REPORT <br /> SAN JOA©UIN HEALTH DISTRICT . <br /> 1601 E. HAZEL-TON <br /> STOCKTON, CA 95205 COUNTY #j--l-7 <br /> COUNTY NAME S� cloaf aw PHONE NO. 468-3423 <br /> SITE NAME: INSPECTION DATE: 3/9Z <br /> Ca ree l/C� �1wes <br /> SITE ADDRESS: rrjpa �� �/ . 'o"ra64f <br /> CITY/STATE/ZIP 5-AC ft+N <br /> CHANGES SITE/OWNER/PERMIT? YES TANK TANK TANK TANK ' <br /> FORM AAND/OR B SUBMITTED? <br /> COMPUTER.. COMPUTER COMPUTER NUMBCOMPER: <br /> NUMBER NUMBER NUMBER NUMBER: <br /> TYPE OF INSPECTION] SITE COMPUTER# PER# PER# PER# PER <br /> O f Sc ► !/' EXP DATE' EXP DATE EXP_DATE EXP DATE <br /> OPERATIONAL TA K ` <br /> MWK CONTENTS <br /> 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 1$ <br /> ACCESS CASING SECURED 17 18 ; <br /> PIPING. 19. 20 <br /> INVENTORY RECONCILIATION 21 22 <br /> TANK GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 25 2B <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 28 <br /> SAMPLING 29 30 ` <br /> APPROVED TANK REPAIRS 31 32 ; <br /> r <br /> UNAUTHORIZED RELEASES REPORTED 33. 34 <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 37- <br /> TEMPORARY <br /> 7 TEMPORARY TANK CLOSURE Am <br /> REMOVAL OF RESIDUAL - - � � - - - <br /> FLAMMABLE VAPORS REMOVED x 40" <br /> *_ <br /> ACCESS LOCATIONS SEALED,' 41 42 <br /> POWER DISCONNECTED 43 - z= <br /> OWNER/OPERATOR MONITORING 44 45 <br /> PERMANENT TANK CLOSURE :a <br /> . .. ,..i: <br /> REMOVAL OF RESIDUAL MATERIALS 46 ..• 47 � <br /> PIPING 48 <br /> FLAMMABLE VAPORS REMOVED 50. <br /> UNAUTHORIZED RELEASE - 51 52. <br /> SAMPLING 53 - 54 <br /> IMPROPER ABANDONMENT 55 58THE MARKED ITEMS R ESENT:VIOLATIONS AN MUST BE CORRECTED AS u <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: S NSI' - OSI uJ <br /> MAJOR 57 MINOR NO 59 x s <br /> VIOL ❑ VIOL ❑ VIOL <br /> OFFICE: (NSP n/Q RECEIVED BY <br /> TITLE <br /> ;� PHONE BECK: <br /> x <br /> G <br /> , ::ORIGINAL . <br />