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OIL <br /> NAME �•J J / <br /> SITE NAME: <br /> k- COUNTY M1Si'ECT10N GATE: r <br /> SITE AOORESS t lY� <br /> IBJti� /STATE/ZIP �• <br /> �/ / D RMfT? YES NO M IANK <br /> j Taj CTS S(TE�OMPIIIER• 10 L of 10• IDo <br /> PER• <br /> PER/ PER 0 PER 0 ' <br /> Z" S ENP.DATE EXP.DATE 1EXP.DATEOPERIUIONAL TANKEXP DATE <br /> I <br /> MA.t K <br /> PERMR 10 OPERATE 1 2 <br /> aWW N OONW M9 TO OPERATE <br /> APPAMW OOMSTRUCTpN 6 6 <br /> WTYTTEM MONTTORM PROCEDURES 7 E <br /> APPROVED MONITORM SYSTEM o 10 <br /> IADrATORAIO sYsmm 11 12 <br /> /APPROVED MOWTOR FREOUENCY p 14 <br /> MONfTORk10 RECORDS MAMMNEO Ist8 <br /> ACCESS CASM SECURED t7 iB <br /> Ppm - 19 20 <br /> NVENTORY RECONCAIATION 2, 22 <br /> TANK GAUD MO 23 24 <br /> APPROVED RESPONSE PLAN 26 _ <br /> UNAUT1pWjE C <br /> r1RELEASE OCCURRENCE 27 28 <br /> sAAAPLD 291 301 1 <br /> APPROVED TMA(REPAIR$ J 1 32 <br /> UNAUTHORIZED RELEASES REPORTED �9 3R <br /> SAFETY HAZARD 35, 38 <br /> CON0n)ONs ABATED <br /> =7137 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 36, J0 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS sEALEo 4 t; 42 <br /> i' POWER D*CONNECTED 40 <br /> OWNER/OPERATOR MON"ORING u �5 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 461 47 <br /> PIPING 449�, 49 <br /> FLAMMABLE wPORS REMOVED 50 <br /> 1 M <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 5-31 61 <br /> IMPROPER ABANDONMENT 551 56 <br /> THE MARKED REEMMSSJREPRE NT VIOLATIONS A O MUST BE CORRECTEO AS <br /> SKTEM STATUS(MUST MARK Or.EI FOLLOWS:—/ <br /> 57 58 50 <br /> MAJORElMINORVIOL VIOOR ❑ NO _ M P r .ihLL+.cti <br /> VIOL L C'[_J <br /> PtJbP�UN LOCAL HEALTH DISTRI NSP. ' n RECEIVED BY: <br /> POST OFFIC[ <br /> STOCKTON. CALIF. 05201 <br /> ffTN: ENVIRON. HEALTH TITLE: �� j, PHONE: BECK: <br /> 7,I1it) o. <br />