Laserfiche WebLink
CHANGE |wCONDITIONS noOPERATE <br />UIWGROUND TANK OFFICIAL INSPECTION R IWTSAN <br />JOAQUIN PUBLIC HEALTH SERVICESENVIRONMENTAL <br />APPROVED CONSTRUCTION <br />HEALTH DIVISION445 <br />N. San Joaquin StreetMailing <br />NAME k <br />Address: P.O. Box 388COUNTY <br />Stockton, CA <br />CIL U C, <br />95201-0388 <br />COUNTY #468-3420SITE <br />*pP90vEoMONITORING SYSTEM <br />NAME: S <br />INSPECTION DATE:IfSITE <br />ADDRESS: 4a <br />- If CITY/STATE/ZIPCHANGES <br />SITE /OWNER/PERMIT? <br />YES NO <br />TANK <br />TANK <br />TANK F <br />TANKFORM <br />A AND/OR B SUBMITTED? <br />COMPUTER <br />NUMBER <br />COMPUTER <br />NUMBER <br />COMPUTER <br />NUMBER <br />COMPUTERTYPE <br />NUMBEREXP.DATE <br />OF INSPECTION <br />APUTER # <br />15 16 <br />ACCESS CASING SECURED <br />17 18 <br />p|P|wG <br />EXP. DATE <br />EXP. DATE <br />EXP. DATE16PE&-nONAL <br />TANK <br />IANK CONTEMAJOR <br />21 22 <br />TANK GAUGING <br />23 24 <br />MIPPERMIT <br />APPROVED RESPONSE PLAN <br />25 26 <br />TO OPERATE <br />1 2 <br />UNAUTHORIZED RELEASE OCCURRENCE <br />27 28- <br />CHANGE |wCONDITIONS noOPERATE <br />APPROVED CONSTRUCTION <br />WRITTEN MONITORING PROCEDURES <br />*pP90vEoMONITORING SYSTEM <br />9 10 <br />MONITORING SYSTEM <br />11 12 <br />APPROVED MONITOR FREQUENCY <br />13 14 <br />MONITORING RECORDS MAINTAINED <br />15 16 <br />ACCESS CASING SECURED <br />17 18 <br />p|P|wG <br />19 20 <br />INVENTORY RECONCILIATION <br />21 22 <br />TANK GAUGING <br />23 24 <br />APPROVED RESPONSE PLAN <br />25 26 <br />UNAUTHORIZED RELEASE OCCURRENCE <br />27 28- <br />SxmpL|m8 <br />-'-- <br />ApPROvEDTANK REPAIRS <br />31 32-'-- <br />---- ' - <br />UNAUTHORIZED RELEASES REPORTED <br />33 34------- <br />- ---' - <br />SAFETY HAZARD <br />35 36'------ <br />--- -' - -- <br />CONDITIONS ABATED <br />-----|- <br />-----� <br />REMOVAL OF RESIDUAL <br />FLAMMABLE VAPORS REMOVED <br />ACCESS LOCATIONS SEALED <br />POWER DISCONNECTED <br />0wwEn/oPsnmnnwOwnnn|wa <br />REMOVAL OFRESIDUAL MATERIALS <br />PIPING <br />FLAMMABLE VAPORS REMOVED <br />UNAUTHORIZED RELEASE <br />SxwPuma <br />IMPROPER ABANDONMENT <br />STATUS <br />38 39 <br />40 <br />-'_- - <br />41 42 <br />** |45 | �-||----------------- '---'|-- - <br />_-(MUST MARK _--, <br />57 un59 <br />MAJOR F-1 MINORVIOL. VIOL. NOn <br />m0 �1 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECT�,D AS <br />7—� <br />"''' //r~_ �/L /mor. - <br />^��y��" <br />" / �- <br />| � <br />////uc� <br />I 11 0 9113 1 <br />HUT -3 White - Oricinal Yellow - Owner's CoDv Pink - File Conv <br />~ <br />