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COUNTY NAME • cy <br /> I f9 <br /> SITE NAME: <br /> �!L f INSPECZTON DATE- <br /> 60 <br /> ATE: j _02�LSc� <br /> SITE AWRESS: i0 <br /> C7TYlSTATE/Z!P <br /> a-VMES SITE/OWNER/PERw? YES NO TANK TANK WWPERMIT SUBMME0 �- TANK IANK ' <br /> TYPE OF IrtSPECTION SITE OOMPUIER• D'r Y--u0,) A I d L�( c« ID• D ill <br /> PER do .5�v �aPEa• r c�C) PER• <br /> E HATE P sl EXP. 12 a <br /> EXP.DATE DATE <br /> OPEEtAT ONAL SANK' MA,t. l41tH. <br /> Ptd TD OPERATE t y <br /> Cs`W KiE N CONC>1T1"70 OP P E 4 <br /> APPROVED CONSTAUCTCH b 0 <br /> WRITTEN MOWr0RtIW PROCEDURES r I-al <br /> -APPROVED MONITORING SYSTEM 1101 <br /> I''10KTORM SYSTEM it 1121 <br /> APPROVED MOWMR FREOUENCY 13 I t4 <br /> MONITORM RECORDS <br /> D is t0 ACCESS CA,StNO SECUREDa +20 <br /> P1P'NO 1D <br /> "EN700Y RECONCISJAT04 21 22 <br /> TANK GAJQlNG ="' <br /> 23j 2• _ <br /> APPROVED RESPel4SE PLAN 25 26 <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 28 <br /> SAMPLING 29 JO <br /> APPROVED TANK REPAJRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED 33 <br /> SAFETY HAZARD 350 36 <br /> C ONOrnONS ABATED 3r <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIOUAL 38. 39 <br /> FLAM&AABL£VAPORS REMOVED 40 <br /> AC -ESS LOCATIONS SEALED 41, 42 <br /> POWER DISCONNECTED 43 <br /> OA114ER/OPERATOR L4oN[TIDRING 44 PERMANENT TANK TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 461 1471 <br /> PIPING 49 49 <br /> 1 1 X1 <br /> r . <br /> FLAMMASLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 52 tAV/ <br /> SAxAPUNG 53 54 <br /> MAPRC)PER ABAh1OONMENT 55 56 <br /> THE LARKED ITEMS REPRESENT%'KXATIQNS AND L%JST BE CORRECTED AS <br /> SYSTEM STATXIS AMUST wAK ONE$ <br /> FOLLOWS. <br /> ks rse in al kn Th L <br /> UAJOR 5i MINOR <br /> vKX_ aVKX <br /> ❑ <br /> S elp0 ccivP <br /> Rh6XPN LOCAL IiEALTH OISTRI NSP RECEtVE0 BY: <br /> POST OFFICC E30X 2009 . <br /> STOCKTON. CALIF. 95201 -177 <br /> N: ENVIRON. HEALTH rl: <br /> PHO* <br />