Laserfiche WebLink
SERGROUND TANK OFFICIAL INSPECTION OORT <br />SAN JOAQUIN PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />445 N. San Joaquin Street <br />Mailing Address: P.O. Box 388 <br />COUNT Y NAME Stockton, CA 95201-0388 <br />468-3420 <br />SITE NAME, <br />< <br />SITE ADDRESS: <br />CHANGES SITE/OWNER/PERMIT? YES NO I TANK 0 <br />FORM A AND/OR B SUBMITTED? I COMPUTER <br />TYPE OF INSPECTION I SITE (nMP1 ITF I UMBER <br />X T: U. -I W ro 2 Rib -11-1 7M, <br />PERMIT TO OPERATE <br />CHANGE IN CONDITIONS TO OPERATE <br />APPROVED CONSTRUCTION <br />WRITTEN MONITORING PROCEDURES <br />APPROVED MONITORING SYSTEM <br />MONITORING SYSTEM <br />APPROVED MONITOR FREQUENCY <br />MONITORING RECORDS MAINTAINED <br />ACCESS CASING SECURED <br />PIPING <br />INVENTORY RECONCILIATION <br />TANK GAUGING <br />APPROVED RESPONSE PLAN <br />UNAUTHORIZED RELEASE OCCURRENCE <br />SAMPLING <br />APPROVED TANK REPAIRS <br />UNAUTHORIZED RELEASES REPORTED <br />SAFETY HAZARD <br />CONDITIONS ABATED <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL <br />FLAMMABLE VAPORS REMOVED <br />ACCESS LOCATIONS SEALED <br />POWER DISCONNECTED <br />OWNER/OPERATOR MONITORING <br />CITY/STATE/ZIP <br />4 <br />TANK <br />TANK <br />COMPUTER <br />COMPUTER <br />NUMBER <br />NUMBER <br />PER # <br />PER # <br />EXP. DATE <br />EXP- DATE <br />COMPUTER <br />NUMBER <br />PER # <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />FLAMMABLE VAPORS REMOVED <br />50 <br />9 <br />10 <br />UNAUTHORIZED RELEASE <br />11 <br />12 <br />13 <br />14 <br />53 54 <br />15 <br />16 <br />IMPROPER ABANDONMENT <br />155 156 <br />17 <br />18 <br />19 <br />20 <br />THE MARKED <br />FOLLOWS: <br />ITEMS REPRESENT VIOLATIONS <br />AND <br />21 <br />22 <br />23 <br />24 <br />MAJOR 57 MINOR 58 <br />VIOL. VIOL. LJ <br />Imu 59 <br />VOL. LJ <br />25 <br />26 <br />---- --------------- <br />27 <br />28 <br />29 <br />30 <br />31 <br />32 <br />RECEIVED BY: <br />TITLE: el <br />If, F— <br />PHONE: <br />BECK: <br />Ht JT—.'l WNte - Oricinal Yellow - Owner's Coov Pink - FRA rnnv <br />�17 <br />38 39 <br />40 <br />41 42 <br />431 <br />44 45 1 <br />PERMANENT TANK CLOSURE <br />REMOVAL OF RESIDUAL MATERIALS 46 47 <br />PIPING <br />48 49 <br />FLAMMABLE VAPORS REMOVED <br />50 <br />UNAUTHORIZED RELEASE <br />51 52 <br />SAMPLING <br />53 54 <br />IMPROPER ABANDONMENT <br />155 156 <br />THE MARKED <br />FOLLOWS: <br />ITEMS REPRESENT VIOLATIONS <br />AND <br />MUST BE CORRECTED AS <br />SYSTEM STATUS (MUST MARK ONE) <br />MAJOR 57 MINOR 58 <br />VIOL. VIOL. LJ <br />Imu 59 <br />VOL. LJ <br />OFFICE: <br />INSP: <br />RECEIVED BY: <br />TITLE: el <br />If, F— <br />PHONE: <br />BECK: <br />Ht JT—.'l WNte - Oricinal Yellow - Owner's Coov Pink - FRA rnnv <br />