Laserfiche WebLink
UNDERGROUMr% TANK PROGRAM OFFICIAL INSPFc'r.ON REPORT <br /> AN JOAQUIN HEALTH DISTRIC 1, <br /> 1601 E. HAZELTON AVE. _ <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY # <br /> PHONE NO. 468-3423 <br /> SITE NAME: INSPECTION DATE:`L J l q o <br /> SITE ADDRESS: gs?� C` �a CITY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTE OMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# t.✓ <br /> .r 71 ` / PER #i,�Al PER# PER# PERAell # <br /> `7 EXP.DATE' d� EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS -T,1�,,,v w <br /> MAJOR MINOR :k. _ <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 9 110 <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 <br /> INVENTORY RECONCILIATION i1>c22 _— <br /> TANK GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 25 26 <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 26 _ <br /> SAMPLING 29 30 <br /> APPROVED TANK REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 755 37 71,01, <br /> a <br /> TEMPORARY TANK CLOSURE ' <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED 40m. <br /> — <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 _ <br /> OWNER/OPERATOR MONITORING 44 45 <br /> PERMANENT TANK CLOSURE ro � �'"� xi. Mix &_ ,. <br /> .. ,. <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 5 56 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS MUST MARK ONE) FOLLOWS: h �S <br /> MAJOR 57 MINOR 58 NO 59Lxe /� <br /> VIOL VIOL. ❑ VIOL ❑ arGlG� fzoi* - <br /> OFFICE: INSP:VRECEIV Y: <br /> TITLE: PHONE: BECK. <br /> 3 <br /> t NUT-3 ORIGINAL 9/88 �k <br />