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UNDERGROUNK PROGRAM OFFICIAL INSP ')N REPORT <br /> N JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE.. �� 1 <br /> STOCKTON, CA 95205 COUNTY # <br /> COUNTY NAME o4t PHONE NO. 468-3423 - <br /> INSPECTION DATE: <br /> SITE NAME: TR rE S <br /> p� CITY/STATE/ZIP ���jfQ j^ C/V <br /> SITE ADDRESS: 9117 O r� �-' <br /> CHANGES SITE/OWNER/PERMIT? TANK D ms•.YES O TANK Q TANK O TANK d <br /> e ..3 <br /> FORM A AND/OR B SUBMITTED? OMPUTER OMPUTER OMPUTER QMPUTER <br /> UMBER UMBER UMBER UIMSER <br /> TYPE OF INSPECTION SITECOMPUTER# R# P R# P R# R# <br /> DATE E DATE E DATE E P DATE <br /> TANK CONTEN75 <br /> OPERATIONAL TANK nn�woR nnlNOR � � _ <br /> PERMIT TO OPERATE 1 2 ei <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 LD. <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 �K... It <br /> p ''ss <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 /> rad a <br /> PERMANENT TANK CLOSUREmo <br /> IN <br /> mi yp g <br /> REMOVAL OF RESIDUAL MATERIALS 46 147 6 <br />{ PIPING 48 149 <br /> FLAMMABLE VAPORS REMOVED 50 vzzzfflAz -" <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 58 59 <br /> NO <br /> VIOLOR ❑ \ROL..R ❑ VIOL❑ <br /> OFFICE: RECEIVED BY: <br /> TITLE:. a4—' : PHONE: BECK: <br /> s <br /> HUT-3 RIGINAL alae O� <br />