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UNDERGROUP - "ANK PROGRAM OFFICIAL INSPF 'ON REPORT O .N JOAQUIN HEALTH DISTRICT �- 1601 E HAZELTON AVE 2 9 COUNTY NAME STOCKT5205 PHONE OO 68N CA -3423 COuliTT # .7 ---E NAME n f ( INSPECTION DATE//— Vzo- S1�DDRESS / _ CITY/STATE/ZIP C.� '75_3740 CHANGES SITE/OWNER/PERMIT'? YES NO TANK t TANKTANK TANK 2ORM A AND/OR B SUBMITTED COMPUTER COMPUTE R�s5- COMPUTER COMPUTER TYPE OF INSPECTION SITE COMPUTER# NUMBER 4-50NUMBER NUMBER NUMBER 7 ••�/ - PER# PER # PER # PER# ��1I9�C ✓ yi EXP DA EXP DATE EXP DATE EXP DATE OPERATIONAL TANK TANK CONTENTS MAJO141 MINOR PERMIT TO OPERATE 1 2 CHANGE IN CONDITIONS TO OPERATE 3 4 --- APPROVED CONSTRUCTION 5 6 WRITTEN MONITORING PROCEDURES 7 S -�- APPROVED MONITORING SYSTEM 9 10 _ - - --- - MONITORING SYSTEM 11 112 APPROVED MONITOR FREQUENCY 13 114 - - - - -- - - - -- --- -- -' MONITORING RECORDS MAINTAINED 15 116 - ACCESS CASING SECURED 17 118 - PIPING 19 20 INVENTORY RECONCILIATION 21 22 TANK GAUGING 23 24APPROVED RESPONSE RESPONSE PLAN 25 28 - - - -- - - -�- UNAUTHORIZED RELEASE OCCURRENCE 27 28 - - --- -- -- -- - -- -- -- - - -- SAMPLING 29 30 - - - - - - --- --- - - APPROVED TANK REPAIRS 31 32 _ - - USHORIZED RELEASES REPORTED 33 34 -- HAZARD 35 36 CONDITIONS ABATED 37 TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 38 39 FLAMMABLE VAPORS REMOVED 40 ACCESS LOCATIONS SEALED 41 42 POWER DISCONNECTED EM 43 OWNER/OPERATOR MONITORING 44 45 PERMANENT TANK CLOSURE REMOVAL OF RESIDUAL.MATERIALS 46 47 PIPING 48 149 FLAMMABLE VAPORS REMOVED [53 UNAUTHORIZED RELEASE 52 SAMPLING 54IMPROPER ABANDONMENT 56 THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED As SYSTEM STATUS(MUST MARK ONE) a_ FOLLOWS -58 1 MAJOR 57 MINOR NO9 VIOL. ❑ VIOL ❑ VIOL. OFFICE INSP RECENED BY TITLE .C � PHONE BECK ORIGINALS �'