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r <br /> UNDERGROU IyK PROGRAM OFFICIAL INSP 74N REPORT , A <br /> S AN JOAQUIN HEALTH DISTRIC <br /> ` _ 1641 E. HAZELTON AVE. coulffY # <br /> �, � <br /> � STOCKTON. CA 95205 -,- <br /> 'IKI•Y HAM PHONE NO. 468-3423 o <br /> INSPECTION DATE:, i - <br /> ,ITE NAME: <br /> : ADDRESS: : �y� ,Q� Z rU - CITY/STATE/Z]P�� /4 <br /> �u' , /LC�v TANK TANK TANK <br /> ;,HANGES SITELO ? S NO TANK COMPUTER COMPUTER <br /> COMPUTER COMPUTER NUMBER , NUMBER <br /> =d^,M A AND/O SUBMITTE NUMBER, NUMBER <br /> PER * PER <br /> +� <br /> OF INSPECTION TE COMPUTER PER PER <br /> UP.DATE EXP.DATE EXP.DATE EXP,-DATE <br /> CF 'ERA-nONAL:TANK MAjdR MINOR <br /> PERMIT TO OPERATE. 1 2 <br /> ' u- ITIONS TO OPERATE 3 4 <br /> D <br /> C, ANGE IN CON ., . <br /> �yy,,��PROVED CONSTRUCTION 5 6 <br /> )4 iTTEN MONITORING PROCEDURES. .. 7 8 <br /> ROVED MONITORING SYSTEM <br /> Vp9 10 <br /> K iN1TORING SYSTEM 11 12 <br /> ROVED MONITOR FREQUENCY 13 14 <br /> koNiTORING RECORDS MAINTAINED 15 16 <br /> 'f-CESS CASING SECURED 17 1$ <br /> fo,1NG 19 <br /> INVENTORY RECONCILIATION:, . 21 . 22 <br /> sntgK GAUGING 23 24 1 <br /> �PROOVED RESPONSE PLAN 25 26 <br /> .bK&j1HO-RiZED RELEASE OCCURRENCE 27 28 <br /> SAMPLING ::: 29 30 <br /> ` 'PROVED TANK REPAIRS 31 32 <br /> L.IAUTHORIZED RELEASES REPORTED 33 34 e <br /> SAFETY HAZARD 3' ' <br /> v <br /> NDITIONS ABATED <br /> 37 # <br /> TEMPORARY TANK CLOSURE ' <br /> L__�Z <br /> AL OF RE5IDUAL 38ABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> LER/OPERATOR <br /> ER DISCONNECTED 43 <br /> MONITORING• 44 45. <br /> I PERMANEN TANK CLOSURE_. , <br /> .:. <br /> _ i;MOVAL OF RESIDUAL MATERIALS 46 47• <br /> - . <br /> 48 49 <br /> , wAS OVER <br /> UTHORIZED RELEASE 51 52 yr <br /> SAMPLING 5354 <br /> APROPER ABANDONMENT 55 L 56 - <br /> s THE MARKED PRIES V101ANNS AND MUST BE CORRECTED.AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS:58 <br /> "MAJOR 57 MINOR NO L <br /> .VIOL_ ❑ VIOL VIO❑ - <br /> FFiCE: INSP: /� RECEIVED BY: - <br /> ` . .. PriONE <br /> RE <br /> TITLE` 'r ' <br /> .. 'ter;• ':�_i � -;:-' -;�,d,. <br /> ' __.�..... ":l s,Y'�is-. �r. � Xi•..:•ti-�•.'�.i d. .r.�!._ a_ ,�`•��'-i�.'-. <br />