Laserfiche WebLink
UNDERGROLOKJANK PROGRAM OFFICIAL INSON REPORT <br /> JAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY # � <br /> PHONE NO. 468-3423 <br /> SITE NAME: ,G - ( J INSPECTION DATE: <br /> SITE ADDRESS: .S7 CITY/S <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK / TANK ANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER { COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE jCOMPUTER# <br /> PER# PER # PER# PER# <br /> EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> aNK comTeµTs <br /> OPERATIONAL TANK <br /> MAJOR MINOR �&a ? i� r• �� ? , h'�� c t o r :, s' <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 <br /> _ INVENTORY RECONCILIATION 21 22 <br /> TANK GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 25 26 <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 28 <br /> SAMPLJNG 29 30 <br /> -- APPROVED TANK REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED _. 33 34 <br /> SAFETY HAZARD = 35 136 <br /> CONDITIONS ABATED 37 <br /> iii. «4.6• " y _#rF st: ``:2 --- 4 i" •; .s - 2*� `�e="� <br /> TEMPORARY TANK <br /> .rti •o .•^t -� <br /> CLOSURE 1 •�+' <br /> . x <br /> 's'.-':'7 +'�.tys�'' : ..a•.�`rr't wJ '..�4ti.+'• 1...`Y,YC, �FS r:F�^`.- ,^- <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 /> VN <br /> PERMANENT TANK CLOSURE. ; u Im a 3 R <br /> r " S mit , <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 . <br /> PIPING 48.; 49. <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE",'.`-r: , `.' 51 52 ' <br /> SAMPLING ;. .. 53 " . 54 <br /> IMPROPER ABANDONMENT55 56 <br /> Q THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) _ <br /> _ FOt1OWS: =Ef x2 <br /> MAJOR 57 MINOR NO �59 <br /> VIOL ❑ VIOL' ❑ VIOL,r�+ <br /> OFFICE: ."INSP: l RECEIVED BY <br /> TIT PHONE: <br /> PHONE: <br /> ; -• ` <br /> r; <br /> HUT-3 ORIGINAL. a <br />