Laserfiche WebLink
UNDERGROU ' TANK PROGRAM OFFICIAL INSP' 'TION REPORT <br /> SAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME21 STOCKTON, CA 95205 COUNTY # CQ S �� <br /> PHONE NO. 468-3423 <br /> SITE NAMES y� 's ���C #�� INSPECTION DATE: <br /> SITE ADDRESS: �- �a CITY/STATE/ZIP ' C159 y5 �� <br /> CHANGES SITE/OWNER/PERMIT? YES N TANK ITANK TANK TANK/ <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TY2E OF INSPECTION SITE COMPUTER# PER # PER # PER# PER # <br /> EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATI NAL TANK TANK CONTENTS <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 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ACCESS CASING SECURED 17 18 <br /> PIPING 19 20 W <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 <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 53 54 <br /> IMPROPER ABANDONMENT 55 56 �- <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED ASS��{ ,L <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: i h / c� L 'e 7�- /'w"yj,/e <br /> 57 58 59 <br /> MAJVIOLVIOL <br /> OR ❑ MINOR <br /> ❑ VIOL.❑ <br /> OFFICE: INSP Laces RECEIVED BY: <br /> P� <br /> TITLE: PHONE: BECK: <br /> HUT-3��t_z z__� ORIGINAL siaa O <br />