Laserfiche WebLink
U GROUND TANK OFFICIAL INSPECTION RiWT <br /> SAN JOAOUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 445 N.San Joaquin Street <br /> Mailing Address: P.O.Box 388 <br /> COUNTY NAME Stockton,CA 95201-0388 COUNTY 468-3420 <br /> SITE NAME: INSPECTION DATE: <br /> /2 <br /> SITE ADDRESS: CITY/STATE/ZIP <br /> CHANGES SITE/O NER/PERMIT? YES !NOr <br /> TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? TER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER# R NUMBER NUMBER NUMBER <br /> PER# PER# PER# PER# <br /> EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS Nyw <br /> MAJOR MINOR <br /> PERMIT TO OPERATE 1 2 __j 21 <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 <br /> APPROVED CONSTRUCTION 5 6 <br /> __. <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 P4 - <br /> APPROVED RESPONSE PLAN 25 26 <br /> _ .. <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 28 <br /> SAMPLING 29 30 <br /> APPROVED TANK REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED 33 134 <br /> SAFETY HAZARD r <br /> 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> x . <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 44 145 <br /> PERMANENT TANK CLOSURE a ; ��`` � <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 49 <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 153 154 <br /> IMPROPER ABANDONMENT 5556 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYS STATUS(MUST MARK ONE) FOLLOWS:MAJ .� <br /> 57 58 59 <br /> VIOL.OR ❑ MINOVIOL.R ❑ VOL.❑ <br /> OFFICE: INSP: RECEIVED <br /> �'1 <br /> TITLE: V_ R S PHONE: RtCK <br /> HUT-3 WhIts-Orloinal yellow-Owner's Coov Pink-t=ile Cnnv <br />