Laserfiche WebLink
UNDERGROUV TANK PROGRAM OFFICIALINSPF 'TIONREPORT <br /> y1N JOAOUIN HEALTH DISTRICT' <br /> 1601 E. HAZELTON AVE. 1� <br /> (o, ' STOCKTON, CA 95205 # <br /> COIIIIT7 NAME ,n � PHONE NO. 468-3423 <br /> SITE NAME: "Ia47� yy INSPECTION DATE: I I iil J <br /> SITE ADDRESS: tel✓ � CITY/STATE/ZIPS CA <br /> CHANGES SITE/OWNER/PERMIT? S NO TANK / TANK rP� TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER <br /> C PER PER r PER M PER <br /> �G J EXP.DATE EXP.DATEEXP.DATE EXP.DATE <br /> OPERATIONAL TAN TANK coNleNrs <br /> MAJOR MINOR <br /> PERMIT TO OPERATE 1 2 '-'_._.-_--.—------- — --- <br /> CHANGE IN CONDITIONS TO OPERATE 3 <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 14 _ <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ACCESS CASING SECURED 17 18 <br /> PIPING 19 20 <br /> INVENTORY RECONCILIATION 21 22 ------ <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 35 <br /> CONDITIONS ABATED 37 <br /> ekK ; z ti <br /> TEMPORARY TANK CLOSURE ., _> <br /> REMOVAL OF RESIDUAL e4b <br /> _ -- - - <br /> FLAMMABLEVAPORSREMOVED ACCESS LOCATIONS SEALED POWER DISCONNECTED OWNER/OPERATOR MONITORING <br /> r° <br /> PERMANENT TANK CLOSURE , <br /> REMOVAL OF RESIDUAL MATERIALS 48 47 __ -- --' "-----'--' <br /> -- <br /> PIPING 48 49 -"- ----- <br /> .--._ _ .. --------- <br /> .- <br /> FLAMMABLE VAPORS REMOVED 50 - <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 53 54 -------- . _ <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> 57 se 59 <br /> VIOL LiV OLL..R ❑ VOL❑ <br /> OFFICE: INS RECEIVED BY: <br /> TITLE: (? fs PHONE: RECK: <br /> siva <br /> HUT-3 ORIGINAL <br />