Laserfiche WebLink
UNDERGROUND <br />COUNTY NAME <br />TANK PROGRAM OFFICIAL INSPE('TION <br />aN JOAQUIN HEALTH DISTRICT <br />1601 E. HAZELTON AVE. <br />STOCKTON, CA 95205 <br />PHONE NO. 468-3423 <br />• .il <br />COUNTY # 3 g <br />SITE NAME: S <br />S C) <br />Q � S <br />INS `ECT ON DAT : <br />SITE ADDRESS: f� <br />j a <br />�\��TY/STATE/ZIP <br />!CHANGES SITE/OWNER/PERMIT? <br />YES <br />NO <br />TANK <br />TANK <br />TANK <br />T NK <br />!FORM A AND/OR B SUBMITTED? <br />COMPUTER ` <br />NUMBER �' �/ <br />PER #�L <br />COMPUTERn <br />NUMBE ,/ <br />PER # � 0 D V <br />COMPUTER <br />NUMBEW O O Q J <br />PER # "\ <br />COMPUT <br />NUM E7% <br />PER a 00 <br />TYP OF INSPECTION <br />SITE COMPUTER # <br />v <br />/ <br />EXP. DATE <br />EXP. DATE <br />EXP- DATE <br />EXP. DATE <br />OPERATIONAL TANKv <br />TANK CONTENTS _ <br />meq, <br />MAJOR <br />MINOR <br />PERMIT TO OPERATE <br />1 <br />2 <br />CHANGE IN CONDITIONS TO OPERATE <br />3 <br />4 <br />_ <br />APPROVED CONSTRUCTION <br />5 <br />6 <br />WRITTEN MONITORING PROCEDURES <br />7 <br />8 <br />_ <br />��- <br />APPROVED MONITORING SYSTEM <br />9 <br />10 <br />MONITORING SYSTEM <br />11 <br />12 <br />APPROVED MONITOR FREQUENCY <br />13 <br />114 <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 />UNAUTHORIZED RELEASE OCCURRENCE <br />27 <br />28 <br />SAMPLING <br />29 <br />30 <br />APPROVED TANK REPAIRS <br />31 <br />32 <br />UNAUTHORIZED RELEASES REPORTED <br />33 <br />34 <br />SAFETY HAZARD <br />35 <br />136 <br />CONDITIONS ABATED <br />37 <br />TEMPORARY TANK CLOSURE <br />77777771 <br />REMOVAL OF RESIDUAL <br />38 <br />39 <br />FLAMMABLE VAPORS REMOVED <br />40 <br />mm <br />ACCESS LOCATIONS SEALED <br />41 <br />42 <br />POWER DISCONNECTED <br />mm <br />43 <br />OWNER/OPERATOR MONITORING <br />44 <br />45 <br />PERMANENT TANK CLOSURE', <br />` <br />REMOVAL OF RESIDUAL MATERIALS <br />46 <br />47 <br />PIPING <br />48 <br />49 <br />FLAMMABLE VAPORS REMOVED <br />UNAUTHORIZED RELEASE <br />50 <br />51 <br />52 <br />_ u <br />� �-�-___,__ <br />_., � __fF <br />�_ _.._ . <br />SAMPLING <br />53 <br />54 <br />IMPROPER ABANDONMENT <br />55 <br />56 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />SYSTEM STATUS (MUST MARK ONE) <br />F LLOWS: f e S <br />e 4L <br />x- <br />57 <br />MAJOR 57 MINOR 58 NO <br />❑ ❑ <br />59 <br />VIOL. VIOL. VIOL. <br />lk /N- ti <br />Ac 2PrtL t.L4. es <br />S <br />L s <br />`.s <br />y O <br />DFFICE: <br />INSP: <br />RECEI BY: <br />TITLE <br />PHONE: <br />R K: <br />JT -3 ORIGINAL 5/88 O <br />