Laserfiche WebLink
UN (GROUND TANK OFFICIAL INSPECTION REPORT <br /> SAN JOAQUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 445 N.San Joaquin Street <br /> Mailing Address: P.O.Box 388 <br /> COUNTY NAME Stockton,CA <br /> 4f58-3420 COUNTY # �jG] <br /> SITE NAME: ` J INSPECTION DATE: <br /> SITE ADDRESS: /1 k� Q,,, CITY/STATE/ZIP,5TDC�} 5Z <br /> CHANGES SITE YE ,U NO TANK TANK D(p TANK ITANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTE1 COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER# NUMBER Z+b NUMBER I �(/� NUMBER NUMBER <br /> w O V l PER# PER# PER# PER# <br /> Z f EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK coNTeNrs <br /> - <br /> MAJOR MINOR <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 13t22 <br /> MONITORING RECORDS MAINTAINED 15 <br /> ACCESS CASING SECURED 17 <br /> PIPING 19 <br /> INVENTORY RECONCILIATION 21 <br /> TANK GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 25 26 �—-- - - <br /> UNAUTHORIZED RELEASE OCCURRENCE 2728 - <br /> SAMPLING 29 30 - —�- <br /> APPROVED TANK REPAIRS 31 32 —y <br /> UNAUTHORIZED RELEASES REPORTED 33 34 " <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED <br /> TEMPORARY TANK CLOSURE �� <br /> Mi <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 a— <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.�6 � ®. <br /> MAJOR 57 MINOR 58 NO 59 K- t <br /> VIOL. ❑ VIOL. ❑ VIOL.❑ �j �j � � ��~ <br /> OFFICE: INSP:k I ja RECEIVED BY: <br /> TITLE-W hOf? PHONE: BECK: <br /> HUT-3 White-Original Yetlow-Owner's Copy Pink-Filo Copv 5/88 QM <br />