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1601 E HAZELTON+AVE. - r <br /> STOCKTON, CA 95205 9 <br /> COUNTY NAME Y l �J Q(e (�jj PHONE NO. 468-3423 ���NT� # 3 / <br /> SITE NAME: G INSPECTION DATE: 7/!Q <br /> SITE ADDRESS- CITY/STATE/ZIP_;z 11Q 0 Z66 �,4fjl-N)4) <br /> C' I <br /> CHANGES SITE/OWNER/PERMIT? YES NO trANK 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# PER# PER # PER# <br /> EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> TANK CONTENTS Y y <br /> OPERATIONAL TANK <br /> MAJOR MINOR it?rte r;# a t, w .' <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 T t <br /> MONITORING SYSTEM 11 12 I <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 <br /> TANK GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 25 26 <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 28 - <br /> SAMPUNG 29 30 - — <br /> APPROVED TANK REPAIRS 31 32 s <br /> UNAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD 35 36 _ I <br /> CONDITIONS ABATED V, 37 _ <br /> TEMPORARY TANK CLOSURE '' �r <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED 40w � — <br /> ACCESS LOCATIONS SEALED 41 42 _- —�— <br /> POWER DISCONNECTED f45 <br /> OWNER/OPERATOR MONITORING 44 _} <br /> 7. <br /> PERMANENT TANK CLOSURE . w s"s-� "`rF �L •' `�`� r �' <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 A <br /> SYSTEM STATUS(MUST MARK ONE) <br /> MAJOR 57 MINOR 58 59 <br /> NO <br /> VIOL. ❑ VIOL_ ❑ VIOL❑ <br /> I <br /> CLQ w <br /> OFFICE: INSP: cp ,_ RE IVED . <br /> TITLE: PHONE: RECK: <br /> MUT-3 ORIGINAL 558 <br />