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UNDERGRWAN <br /> ANK PROGRAM OFFICIAL I TION REPORT <br /> n JOAQUIN HEALTH DISTR <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY # <br /> PHONE NO. 468-3423 <br /> SITE NAME: a 6 S INSPECTION DATE:�?-$Z <br /> SITE ADDRESS: 3 CITY/STATE/ZIP �� ,� <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK d/ TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER# PER# PER# PER# , <br /> Q ©� 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 <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 c <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 — -- -- <br /> UNAUTHORIZED RELEASES REPORTED 33 <br /> SAFETY HAZARD 35 <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 _ w_..._•-•• --.__-. <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 _._. .__,._ .-•-- -"" <br /> SAMPLING 153 154 <br /> IMPROPER ABANDONMENT 155 156 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: � i rc o <br /> MAJOR* 57 MINOR 58 NO 59 S <br /> VIOL. El VIOL. ❑ VIOL. <br /> v <br /> OFFICE: INSP: *PH <br /> 4Q1Y: <br /> TITLE: /' RECK. <br /> L�- <br /> 5/88 �^' <br /> HUT-3 ORIGINAL <br />