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UNDERGROU[f< TANK PROGRAM OFFICIAL INSPI'`"?'TION REPORT <br /> 6dSAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> STOCKTON, CA 95205 <br /> � � E �Q� u_ z PHONE NO. 468-3423 COUNTY# ,•.3 <br /> SITE NAME: fg l �` INSPECTION DATE: <br /> �N&? <br /> SITE ADDRESS:c� /V � � ��Q CITY/STATE/ZIP��� C,/J /�S�d5 <br /> RANGES SITE/OWNER/PERMIT? YES NO TANK a TANK 0 TANK 3 /7` TANK <br /> ORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF NPPECTION SITE COMPUTER#k NUMBER NUMBER NUMBER!,t? NUMBER <br /> PER# PER# PER# PER# <br /> �C d EXP.DATE' EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK "" coHre�ns <br /> MAJOR I 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 13 114 <br /> MOWTORING RECORDS MAINTAINED 15 116 <br /> ACCESS CASING SECURED 17 18 <br /> PIPING 19 20 <br /> INVENTORY RECONCILIATION 21 22 <br /> 1ANC GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 2E <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 85 36 " <br /> CONDITIONS ABATED Vl37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 139 <br /> FLAMMABLE VAPORS REMOVED 40 Vmlllffl <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 <br /> OWNER/OPERATOR MONITORING 44 45 <br /> i <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 49 <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 153 154 <br /> IMPROPER ABANDONMENT 156 156 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> 59 <br /> MAJOR 57 MINOR 58 NO <br /> VIOL VIOL ❑ VIOL❑ <br /> OFFICE: INSP: BY.yyi fd <br /> TIT : ,LaAva 0,4 dc <br /> , <br /> HUT-3 ORIGINAL was O <br />