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UN ROUND TANK OFFICIAL INSPECTION REPO <br />SAN JOAOUIN PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEA�TH DIVISION <br />304 E. Weber Ave., hard Floor <br />Mailing Address: P.O. Box 388 <br />COUNTY NAME Stockton . , CA 95201-0388 COUNTY <br />'SITE NAME: INSPECTION DATE: <br />0;� CITY/STATE/ZIP <br />SITE ADDRESS: <br />CHANGES SITE /OWNER/PERMIT? YES <br />FORM A AND/OR B SUBMITTED? <br />TYPE OF INSPECTION SITE COMPUTER <br />e7 c Y. 0 e_- <br />NO <br />TANK 7$-j <br />COMPUTER <br />NUMBER <br />PER # <br />EXP. DATE <br />TANK <br />COMPUTER <br />NUMBER <br />PER <br />EXP. DATE <br />TANK <br />COMPUTER <br />NUMBER <br />PER <br />EXP. DATE <br />'TANK <br />COMPUTER <br />NUMBER <br />PER <br />EXP. DATE <br />OPERATIONAL TANK <br />TANK COMENts <br />48 <br />mikj6fi miii6fi <br />50 <br />PERMIT 10 OPERATE 1 2 <br />CHANGE IN CONDITIONS TO OPERATE <br />3 <br />4 <br />52 <br />APPROVED CONSTRUCTION <br />5 <br />6 <br />WRITTEN MONITORING PROCEDURES <br />7 <br />.8 <br />1 <br />1 <br />APPROVED MONITORING SYSTEM <br />9 <br />10 <br />112 <br />MONITORING SYSTEM <br />11 <br />APPROVED MONITOR FREQUENCY <br />13 <br />14 <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 />36 <br />CONDITIONS ABATED <br />37 <br />REMOVAL OF RESIDUAL <br />FLAMMABLE VAPORS REMOVED <br />LRESIDUSA <br />L <br />VAPORS REMOVED <br />ACCESS LOCATIONS SEALED <br />POWER DISCONNECTED <br />OWNER/OPERATOR MONITORING <br />PERMANENT TANK CLOSURE <br />REMOVAL <br />PIPING <br />FLAMMABLE VAPORS REMOVED <br />UNAUTHORIZED RELEASE <br />SAMPLING <br />IMPROPER ABANDONME NT <br />STATUS (MUSE MARK ONE) <br />57 58 59 <br />MAJOR MINOR Ej NO F] <br />VIOL. VIOL. VIOL <br />OFFICE: INSP- <br />TITLE: <br />THE MARKED ITEMS REPRESENT VIOLAI ION6 AND PAU61 BE UUHHEL, I ttJ AJ <br />FOLLOWS: Ake -Q5- -7-z"", <br />FlUxeWma" <br />BECK: <br />HUT -3 white -original Yellow - Owner's Copy Pink - File Copv <br />PHS 178 (4/96) <br />46 <br />47 <br />48 <br />49 <br />—m <br />50 <br />51 <br />52 <br />53 <br />54 <br />55 <br />56 <br />1 <br />1 <br />57 58 59 <br />MAJOR MINOR Ej NO F] <br />VIOL. VIOL. VIOL <br />OFFICE: INSP- <br />TITLE: <br />THE MARKED ITEMS REPRESENT VIOLAI ION6 AND PAU61 BE UUHHEL, I ttJ AJ <br />FOLLOWS: Ake -Q5- -7-z"", <br />FlUxeWma" <br />BECK: <br />HUT -3 white -original Yellow - Owner's Copy Pink - File Copv <br />PHS 178 (4/96) <br />