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AUNDERGROUWLTANK PROGRAM OFFICIAL INSP ION REPORT <br />AN JOAQUIN HEALTH DISTRICT <br />1601 E. HAZELTON AVE. <br />COUNTY NAME <br />TANK CONTENTS <br />STOCKTON, CA 95205 <br />PHONE NO. 468-3423 <br />COUNTY # <br />MAJOR MINOR <br />SITE NAME:Aq�tg <br />A. <br />1 <br />2 <br />INSPECTION DATE: C <br />SITE ADDRESS:�'3 <br />-7 T�A G <br />�V� <br />CITY/STATE/ZIP <br />CHANGES SITE/OWNER/PERMIT? <br />YES NO <br />TANK <br />TANK <br />rjj TANK -3 <br />8 <br />TANK <br />FORM A AND/OR B <br />SUBMITTED? <br />COMPUTER <br />COMPUTER <br />COMPUTER <br />11 <br />COMPUTER <br />eTAJ <br />APPROVED MONITOR FREQUENCY <br />NUMBER <br />NUMBER <br />NUMBER <br />MONITORING RECORDS MAINTAINED <br />NUMBER <br />TYPE OF INSPECTION <br />SITE COMPUTER # <br />T'jNQ/ <br />18 <br />Q <br />/ O <br />PER # <br />EXP. DATE <br />PER # <br />EXP. DATE <br />PER # <br />EXP. DATE <br />PER # <br />EXP. DATE <br />OPERATIONAL TANK <br />TANK CONTENTS <br />•38 <br />139 <br />MAJOR MINOR <br />47PIPING <br />PERMIT TO OPERATE <br />1 <br />2 <br />VAPORS REMOVED <br />CHANGE IN CONDITIONS TO OPERATE <br />3 <br />4 <br />51 <br />APPROVED CONSTRUCTION <br />5 <br />6 <br />54 <br />WRITTEN MONITORING PROCEDURES <br />7 <br />8 <br />m. <br />APPROVED MONITORING SYSTEM <br />9 <br />10 <br />MONITORING SYSTEM <br />11 <br />12 <br />eTAJ <br />APPROVED MONITOR FREQUENCY <br />13 <br />14 <br />VIOL. VIOL. VIOL. <br />MONITORING RECORDS MAINTAINED <br />15 <br />16 <br />ACCESS CASING SECURED <br />17 <br />18 <br />PIPING <br />19 <br />20 <br />INVENTORY RECONCILIATION <br />21 <br />22 <br />TANK GAUGING <br />23 <br />24 <br />APPROVED RESPONSE PLAN <br />25 <br />26 <br />�� m <br />UNAUTHORIZED RELEASE OCCURRENCE <br />27 <br />28 <br />SAMPLING <br />29 <br />------------ <br />30 <br />APPROVED TANK REPAIRS <br />31 <br />32 <br />UNAUTHORIZED RELEASES REPORTED <br />33 <br />34 <br />SAFETY HAZARD <br />35 <br />36 <br />CONDITIONS ABATED <br />/ <br />37 <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL <br />•38 <br />139 <br />FLAMMABLE VAPORS REMOVED <br />47PIPING <br />40 <br />M <br />ACCESS LOCATIONS SEALED <br />VAPORS REMOVED <br />41 <br />42 <br />POWER DISCONNECTED <br />51 <br />52 <br />43 <br />OWNER/OPERATOR MONITORING <br />54 <br />44 <br />45_ <br />PERMANENT TANK CLOSURE <br />REMOVAL OF RESIDUAL MATERIALS <br />46 <br />47PIPING <br />48 <br />49FLAMMABLE ;77 <br />VAPORS REMOVED <br />50 <br />UNAUTHORIZED RELEASE <br />51 <br />52 <br />SAMPLING <br />53 <br />54 <br />IMPROPER ABANDONMENT <br />155 <br />156 <br />THE MARKED <br />SYSTEM STATUS (MUST MARK ONE) <br />FOLLOWS:- <br />57 58 <br />59 <br />eTAJ <br />MAJOR MINORNO <br />® ❑ <br />❑ <br />VIOL. VIOL. VIOL. <br />OFFICE: <br />TITLE: 96W,5 <br />i <br />HUT -3 ORIGINAL <br />REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />Ply S i h Al <br />e%- C8N N&A('Z q L-v/'�✓/ <br />IEC B : <br />'HONE: RECK: <br />5/88 Q M <br />