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SITE HISTORY
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELKHORN
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1050
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2900 - Site Mitigation Program
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PR0505234
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SITE HISTORY
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Entry Properties
Last modified
8/1/2019 2:58:23 PM
Creation date
8/1/2019 2:14:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE HISTORY
RECORD_ID
PR0505234
PE
2951
FACILITY_ID
FA0001103
FACILITY_NAME
Elkhorn Golf Club
STREET_NUMBER
1050
STREET_NAME
ELKHORN
STREET_TYPE
DR
City
STOCKTON
Zip
95209
CURRENT_STATUS
02
SITE_LOCATION
1050 ELKHORN DR
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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urnucnunvul vrirvn rnuunram urrn,irlLi- uvor IVIv n�rvn <br /> SAN JOAQUIN HEALTH DISTRICT Y. <br /> 1601 E. HAZELTON AVE. M <br /> COUNTY NAME it STOCKTON, CA 95205 COUNTY # <br /> /� /P�HO7NE NO. 468-3423 <br /> SITE NAME: I5I K� orn (,OU Clt)6 INSPECTION DATE: 5-)�z//9q/ <br />''. SITE ADDRESS: 105D El Khorn CITY/STATE/ZIP <br /> I <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK iV O/ TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> PES DOFF INSPE T N Q SITE/CO(MMPO R+ PER# PER# PER PER# <br /> Koo �YI� �P.I�IJy'4 �`�" �Dl0 EXP.DATE- - EXP.DATE EXP DATE EXP.DATE <br /> INNK CONTENTS OPERATIO AL TANK AOR MINOR K 4 <br /> PERMIT TO OPERATE 1 2 If <br /> j 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 3 <br /> APPROVED MONITOR FREQUENCY 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 1 ,. <br /> ACCESS CASING SECURED 17 18 <br /> PIPING - 19 20 <br /> j INVENTORY RECONCILIATION 21 22 an <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 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE _ <br /> 1 NMI <br /> . � <br /> j REMOVAL OF RESIDUAL38r45 <br /> I <br /> FLAMMABLE VAPORS REMOVED 40 <br /> 1' <br /> ACCESS LOCATIONS SEALED 41 <br /> POWER DISCONNECTED <br />' <br /> OWNER/OPERATOR MONITORING 44 <br /> PERMANENT TANK CLOSURE ±4 r <br /> 111 REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> iI PIPING 48 49 i <br /> I FLAMMABLE VAPORS REMOVED 50 <br />'I UNAUTHORIZED RELEASE 51 52 <br /> Ali SAMPLING 53 54 IMPROPER ABANDONMENT 55 56 r <br /> lil THE MARKE LITEMQSn REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />' SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> MAJOR 57 58 <br /> MINOR NO <br /> VIOL Li VIOL ❑ VIOL <br /> ii <br /> I7 <br /> OFFICE: <br /> INSP-Yam IO(c+4- RECEIVED BY: <br /> TITLE:enV, 4W* PHONE: BECK: <br /> Om <br /> HUT-3 ORIGINAL - <br /> I <br /> J <br />
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