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Izo2�,/ _ <br /> 1 <br /> COUNTY NAME • 77 <br /> SUE NAME: L/ INSPECTION()ATE: <br /> r l Tkrr <br /> SITE ADDRESS: 67Y t <br /> a CITY/STATE/ZIP 5n <br /> LAk <br /> CIAANfaES SUE/OWNER/PERMR? S NO TANK TAM( IlAw TgNI( <br /> MFR/PERMIT SUBMITTED i/L-7- <br /> TYPE OF INSPECTION SITE COMPUTER• D I q I p <br /> PER• PER• PER• PER• <br /> EXP.DATE EXP.DATE EXP.DATE EXP WE <br /> OPERATIONAL TANK M/W. MIN. <br /> PERWT TO OPERATE 1 2 <br /> CHANGE IN OONDRIONS TO OPERATE 31 4 <br /> APPROVED CONSTRUCTION N s 16 <br /> VVRfTTEN MONITORING PROCEDURES A) 7 B <br /> APPROVED MONITORING SYSTEM E 0NA <br /> MONITORING SYSTEM OPERAlicwAt_-E 11 <br /> APPROVED MONITOR FREOUENCY N 13 14 <br /> MONfTORING RECORDS MAINTAINED 6 151 y 18 1 N O <br /> y ACCE3S CASING SECURED 17 18 <br />°N PIPING 19 20 <br /> 1 F- <br /> INVENTORY RECONCILIATION E 21' 221 1 <br /> TAW GAUGING E 231241 F— <br /> APPROVED RESPONSE PLAN N 251261 1 <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 1 261 1 <br /> SAMPLING 291 30 <br /> APPROVED TANK REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD 35 36 <br /> 1, <br /> CONDITIONS ABATED a37 <br />+ TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38. 39 <br /> FLAMMABLE VAPORS REMOVED 40 MINIA <br /> ACCESS LOCATIONS SEALED 41! 42 <br /> 1 1 <br /> POWER DISCONNECTED u <br /> OWNER/OPERATOR MONITORING a4. t51 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46, T471 I <br /> PIPING 4fi 49 <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE St 52 <br /> SAMPUNG `a7 54 <br /> IMPROPER ABANDONMENT 55 58 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONEI FOLLOWS' 44;4 —l.(/N,Tf1CLV�-T/©1� f'!n•—� <br /> =)R S/ MINOR — <br /> NO 59 <br /> VIOL VIOL VIOLEj <br />.Sd,PqbQUN LOCAL IiEALTH OISIII NSP: RECENED BY: <br /> POST OFFICC BOX 2009 <br /> STOCKTON. CALIF. 95201 <br /> AJTN: ENVIRON. HEALTH TTTLE:� PHONE: RECK: 771 <br />