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UNDERGROUANK PROGRAM OFFICIAL INSPE ION REPORT <br /> AN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME sTocKTNO. CA 95205 COUNTY # <br /> PHONE NO. 468-3423 <br /> SITE NAME: / �I, j INSPECTION DATE/ <br /> SITE ADDRESS: 7Z /J L, CITY/STATE/ZIP '7" �jS'37 <br /> CHANGES SITE/OWNER/PERMIT? YES/ NO TAKK TANK TANK '-7 TANK <br /> FORM A AND/OR B SUBMITTED? COMPUT COMPU ERP COMPUTERV& COMPUTE <br /> NUM ��1 U NUMB ] U UMBER NUMBER <br /> TYPE OF INSPE TION SITE O PUTER# PER & PER —� E o/�� PER <br /> K� EXP.DA �� EXP.DATE XP.DATE ' 5 EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR MINOR <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 _r <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 /> SAMPLING 29 30 <br /> APPROVED TANK REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 A_ <br /> OWNER/OPERATOR MONITORING 44 45 <br /> PERMANENT TANK CLOSURE <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 55 56 — <br /> THE MARKE I EMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOW <br /> MAJOR 57 MINOR 58 NO X�59 <br /> VIOL. E:] VIOL LJVIOL.,X <br /> V / <br /> OFFICE: INSPJ,f R EIVED BYE <br /> Gam" _ �'PIP <br /> �� � TITLE: Q�,� 1 �� HONE: �y�� � BECK: <br /> HUT-3 `J ORIGINAL 5/88 0m <br />