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UNDERGROC'I TANK PROGRAM OFFICIAL INSPr-'ION REPORT <br /> SAN JOAQUIN HEALTH DISTRIC-,.,, <br /> 1601 E. HAZELTON AVE. <br /> COUNTY HANE STOCKON, CA 96205 <br /> �k PHONE TNO. 468-3423 COUNTY # �/ <br /> SITE NAME: mQvi INSPECTION DATE: �l6/ <br /> SITE ADDRESS: CITY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? Y NO TANK pt TANK 0 TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPU R# NUMBER NUMBER NUMBER NUMBER <br /> r PER# l�q PER# % PER# PER# <br /> EXP DATE 7 EXP DATE EXP DATE EXP DATE <br /> OPERATIONAL TANK TANK COnirErirs x _� � <br /> MAJOR MINOR l� r 43 <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 14 -- <br /> MONITORING RECORDS MAINTAINED 15 16 - <br /> ACCESS CASING SECURED 17 18 <br /> PIPING E29i3O <br /> 20 <br /> INVENTORY RECONCIUATION 22 - - <br /> TANK GAUGING 24 —- <br /> APPROVED RESPONSE PLAN 28 <br /> UNAUTHORIZED RELEASE OCCURRENCE 28 - — - - <br /> SAMPLING ----- --- <br /> APPROVED TANK REPAIRS 32 _-._._�.. ____ _UNAUTHORIZED RELEASES REPORTED 34 ---- <br /> - — -- - <br /> SAFETY HAZARD35 136 <br /> CONDITIONS ABATED <br /> 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED 41 42 ' <br /> POWER DISCONNECTED - <br /> 43 <br /> OWNER/OPERATOR MONITORING 44 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING48 49 <br /> FLAMMABLE VAPORS REMOVED �------ <br /> UNAUTHORIZED RELEASE 51 52 JJJ111 ��� <br /> SAMPLING53 54 <br /> IMPROPER ABANDONMENT <br /> SYSTEM STATUS(MUST MARK ONE) -- <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MU/ST BE CORRECTED AS <br /> 4 4�& vA< FOLLOWS:--rdN 2- S-0 Gi,( /PSP( ekcc, TrON <br /> obSPrvecx"Aty'z �f'„58 i i 69 r dN <br /> eylp <br /> MAJOR 57 IUINOR NO �j <br /> VIOL. ❑ VIOL. ❑ VIOL La <br /> OFFICE: INSP: RECEIVED BY: <br /> TITLE: �. 1- PHONE: BECK: <br /> NUT-3 ORIGINAL 5/88 <br />