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UNDERGROV: 'D TANK PROGRAM OFFICIAL INS, TION REPORT <br /> tom. SAN JOAQUIN HEA1601 E_ aLITH DISTRICT, <br /> COUNTY NAME ` �Q{,� STOCKTON, CA 95205 <br /> PHONE NO. 468-3423 COUNTY # 3 <br /> SITE NAME: PQGKi✓1 INSPECTION DATE: l /OQ <br /> SITE ADDRESS: q Q y /(fie #fe_Wa_n.., LkZ., CITY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANKp f TANK Q�.., TANK TANK <br /> FORM A AND/OR B SUBMITTED? OMPUTER CMPUTER COMPUTER COMPUTER <br /> TYPE OF 1 §PECTION n SITE COMPUTER# UMBER URMBER NUMBER NUMBER <br /> r7i 1��PiWI.CJ�J tf.,�C 3 C� 7 P R# P # PER# PER# <br /> E DATE EDATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS m ``G siw <br /> MAJOR MINOR <br /> PERMff 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 9 110 <br /> MONITORING SYSTEM 11 112 <br /> APPROVED MONITOR FREQUENCY 13 14 - <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ACCESS CASING SECURED 17 18 j <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 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 <br /> OWNER/OPERATOR MONITORING 44 45 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 49 <br /> FLAMMABLE VAPORS REMOVED 50 mg <br /> • --_--- —____ �_. _. �., .___.,___. <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: S] <br /> v 61 <br /> 57 58 59 <br /> MAJOR MINOR NO <br /> VIOL VIOL ❑ VIOL.-❑ <br /> OFFICE: INSP- RECEIVED BY: <br /> TIT 'w""'� PHONE: BECK: <br /> HLIT-3 ORI INAL [chi 5/88 <br />