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UNDERGROUN NK PROGRAM OFFICIAL INSPEJrN REPORT <br />N JOAOUIN HEALTH DISTRICT <br />PERMANENT TANK CLOSURE <br />1601 E. HAZELTON AVE. <br />COUNTY NAME <br />STOCKTON, CA 95205 <br />COUNTY # <br />_.. <br />PHONE NO. 468-3423 <br />PIPING <br />48 49 <br />SITE NAME:,^ <br />�:. �4 <br />INSPECTION DATE:IAI <br />5 <br />50 <br />SITE ADDRESS: (2� <br />j I 'f-jc4L/v CITY/STATE/ZIP <br />CHANGES SITE/OWNER/PERMIT? <br />YES NO TANK TANK �� <br />TANK -3 <br />TANK <br />FORM A AND/OR B SUBMITTED? <br />COMPUTEA COMPUTER <br />NUMBER 25j900 NUMBER <br />COMPUTER COMPUTER <br />UMBEv NUMBER <br />F SITE COMPUTER <br />!/OQOO <br /># <br />IMPROPER ABANDONMENT <br />TYPE INSPECTION <br />2 PER # D u PER # t/(- <br />PER # A (/ G , <br />PER # <br />�� �� <br />�/ EXP. DATE EXP. DATE <br />EXP. DATE i <br />EXP. DATE <br />SYSTEM STATUS (MUST MARK ONE) <br />co o r mew <br />—(o,,.357 <br />OPERATIONAL TANK <br />TANK CONTENTS ---------------------- <br />59 <br />NO <br />VOL. © <br />/Z <br />MAJOR MINOR <br />g <br />- _ <br />G rte O.J <br />PERMIT TO OPERATE <br />1 2 <br />R S r <br />CHANGE IN CONDITIONS TO OPERATE <br />3 4 <br />APPROVED CONSTRUCTION <br />5 6 <br />l`5 dbW r-3 IDP- I°yiRb A.�r <br />WRITTEN MONITORING PROCEDURES <br />7 8 <br />INSP: <br />APPROVED MONITORING SYSTEM <br />9 10 <br />MONITORING SYSTEM <br />11 12 <br />APPROVED MONITOR FREQUENCY <br />13 14 <br />PHOW. <br />MONITORING RECORDS MAINTAINED <br />15 16' <br />ORIGINAL <br />5isa O <br />ACCESS CASING SECURED <br />17 18 <br />PIPING <br />19 20 <br />INVENTORY RECONCILIATION <br />21 22 <br />TANK GAUGING <br />23 24 <br />APPROVED RESPONSE PLAN <br />25 26 <br />UNAUTHORIZED RELEASE OCCURRENCE <br />27 28 <br />SAMPLING <br />29 30 <br />APPROVED TANK REPAIRS <br />31 32 <br />UNAUTHORIZED RELEASES REPORTED <br />33 34 <br />µµµµT <br />SAFETY HAZARD <br />35 36 <br />CONDITIONS ABATED <br />37 <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL <br />38 39 <br />FLAMMABLE VAPORS REMOVED <br />40 <br />ACCESS LOCATIONS SEALED <br />41 42 <br />POWER DISCONNECTED <br />43 <br />OWNER/OPERATOR MONITORING <br />44 45 <br />PERMANENT TANK CLOSURE <br />REMOVAL OF RESIDUAL MATERIALS <br />46 47 <br />_.. <br />PIPING <br />48 49 <br />FLAMMABLE VAPORS REMOVED <br />50 <br />UNAUTHORIZED RELEASE 51 52 <br />SAMPLING <br />53 54 <br />IMPROPER ABANDONMENT <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />FOLLOWS: Lf <br />SYSTEM STATUS (MUST MARK ONE) <br />co o r mew <br />—(o,,.357 <br />58 <br />MINORMAJOR <br />VIOL. ❑ VIOL. ❑ <br />59 <br />NO <br />VOL. © <br />/Z <br />g <br />- _ <br />G rte O.J <br />R S r <br />o2 IS 0t-aI tcl itj <br />W IoAe4m, Kopj^0 <br />l`5 dbW r-3 IDP- I°yiRb A.�r <br />OFFICE: <br />INSP: <br />RECEIVED BY: <br />�O <br />TITLE: <br />PHOW. <br />RECK: <br />HUT -3 <br />ORIGINAL <br />5isa O <br />