Laserfiche WebLink
i� UNDERGROU��D TANK PROGRAM OFFICIAL INSPFCTION REPORT <br /> �" 'AN JOAQUIN HEALTH DISTRIC*' <br /> + v 1601 E,. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY # <br /> PHONE NO, 468-3423 1f <br /> SITE NAME: INSPECTION DATE: <br /> SITE ADDRESS: CITY/STATE/ZIP <br /> GRANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER } NUMBER ' NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER# Z?ll. _61 PER# PER# PER# <br /> f Llrl f�Cvlt ci✓ C� ? � EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> t a.�tr FffM F ✓��." £ i 4 -i $ mit S" & !. <br /> ENTS ' " a c ..r� c y?.ra ,'c° r.�,r, §^ °&''. +qt, - <br /> TANK CONT -, `"- <br /> OPERATIONAL TANK � as <br /> MAJOR MINOR a .ka ca " tza: n. £ kaz <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 —µ <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 is _ <br /> TANK GAUGING 23 24 _ <br /> APPROVED RESPONSE PLAN 25 26 <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 28 <br /> SAMPLING 29 130 114 —� <br /> APPROVED TANK REPAIRS 31 32 Ij <br /> UNAUTHORIZED RELEASES REPORTED 33 34 !, — <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED <br /> 4 #' �ag'e� ;�"`-s-�, �.S.a� �.r�r.,""ga.�a "'� � ° z * s d a-s .� •�`t' S ��s-d'`:. <br /> TEMPORARY TANK CLOSURE ��. n— <br /> REMOVAL OF RESIDUAL 38 39 E is <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 <br /> OWNER/OPERATOR MONITORING 44 45 <br /> rirpfc ,� ,: �p[,tF �' . <br /> PERMANENT TANK CLOSURE �� r � t p ;F4u <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 r <br /> PIPING 48 49 — <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 ONES FOLLOWS: 4/.rass� �� ✓ ��� <br /> MAJOR Q MINOR NO 58 59 cs �rv`sy <br /> VIOL. VIOL. VIOL <br /> OFFICE: INSP: RECEIVED BY: <br /> TITLE: j5-,jE:L5 PHONE: BECK: <br /> r, <br /> r <br /> O <br /> HUT-3 ORIGINAL Sss � <br /> r <br />