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'(`V�� COUNTY NAME ? <br /> . <br /> SITE NAME: INSPECTKNJ DATE: <br /> SITE ADDRESS. 4 ALF 1 CITY/STATE/ZIP rcl <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK J TANK <br /> MFWPERMIT SUBMITTED <br /> TYPE of NSPECTKk1 SITE Cor LATER• °` I s Ia 4-voo � o• I y Y u�1 0• u• e: <br /> /'7 PER• Sz;� PER♦ cv 0 PER• PER• i <br /> 14 <br /> �I` rnUV cN s(q EXP.DATE p I P S2/ EXP.DATE 12e E"I.DATE EXP DATE <br /> OPERATIONAL TANK MA.L MIN. <br /> PETb fT TO OPERATE 1 2 - <br /> CRANOE N OONDalONS TO OPERATEJ 141 <br /> APPROVED CONSTRUCTION 6 d <br /> YA'WMN MON(TORNO PROCEDURES 7 lal <br />( -APPROVED MOMTORINO SYSTEM 9 1101 <br /> MONrTORING SYSTEM 11 112 <br /> APPROVED MOMTOR FREOUEN CY 13 114 <br /> MONrFORNO RECORDS MARCDUNED 151 lie <br /> ACCE3S CASNO SECURED 17 lie Il <br /> PtPtN/0 19 120 <br /> NVENTORY RECONCILIATION 21' 1221 1 �.. <br /> TANK GAlKW4G 23 1241 <br /> APPROVED RESPCwSE PUN 251 1281, •' <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 . 20 <br /> SA APLNG 29' 30 . <br /> APPROVED TANK REPAJRS 31 32 <br /> LPWfn4ORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD 35, 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL <br /> FLAMMABLE VAPORS REMOVED JAO <br /> i <br /> ACCESS LOCAnONS SEALED at: a2 <br /> POWER OISCONNECTED aJ ti <br /> OWNER/OPERATOR MON(TORtNG a,, a5i <br /> i <br /> I <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RE SIOUAL MATERIALS 46147 <br /> RPING a9 <br /> FLAMMABLE VAPORS REMOVED 77v <br /> 50 <br /> UNAUTHORIZED RELEASE St 52 <br /> SAMPLNG SJ 54 <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED RIO <br /> EMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS IMl)ST MARK a41 . <br /> FOLLOWS: Q..L58 so Rosh ks r —I Thor L <br /> MAJOR 57 IANOR NO <br /> VIOL VLDL ❑ VIOL❑ <br /> Sep qg a e <br /> R5 QUN LOCAL IIEALTH DISIRII NSP: RECEIVED BY. <br /> POST OFFICE 00% 2009f ?� <br /> CK <br /> STOCKTON�t. CALIF. 95201 � <br /> N: ENVIRON. HEALTH j PHONE, T'E <br /> 0- <br />