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UNDERGROU TANK PROGRAM OFFICIAL INSP TION REPORT <br /> WSAN JOAQUIN HEALTH DISTRICTV <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAMEQ L STOCKTON, CA 95205 COUNTY # <br /> `'� PHONE NO. 468-3423 39 <br /> SITE NAME: Frej !�-' INSPECTION DATE: <br /> SITE ADDRESS: Z qV-�- �ivoh�ctO /, b CITY/STATE/ZIP �� q5;?o Z/ <br /> CHANGES SITE/OWNER/PERMIT?? YES NO UT�ANK TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTIO In* SITE COMPUTER# NUMBER 1000 NUMBER NUMBER NUMBER <br /> f t PER# W�O, PER# PER# PER# <br /> `j•'j�) 'Y� EXP.DATE EXP.DATE EXP.DATE 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 _ d <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 r <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 <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 w <br /> SAMPLING 53 54 <br /> IMPROPER ABANDONMENT 155 56 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: Sec Ccm <br /> 59 <br /> MAJOR 57 MINOR o NO <br /> VIOL. VIOL. VIOL. <br /> OFFICE: INSP: 116 RECEIVED BY: <br /> T" I/ <br /> TITLE: Env' ` PHONE: BECK: <br /> Ay/p IM <br /> HUT-3 ORIGINAL Sias 0M <br />