COMPLIANCE INFO_1989-1998 - Laserfiche WebLink

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UNDERGROU TANK PROGRAM OFFICIAL INSP TION REPORT AN JOAQUIN HEALTH DISTRICT 1601 E. HAZELTON AVE. COUNTY NAME STOCKTON, CA 95205 COUNTY # PHONE NO. 468-3423 SITE NAME: K INSPECTION DATE: a` SITE ADDRESS: �oe� �" 2�h' TY/STATE/ZIP $ ,4z� C9" CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK TANK FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER NUMBER NUMBER NUMBER NUMBER TYPE OF INSPECTION SITE COMPUTER # PER # / PER # p PER # CU 3 PER # <x Al ",a �/'// EXP. DATE EXP. DATE EXP. DATE EXP. DATE OPERATIONAL TANK TANK CONTENM MAJOR MINOR PERMIT TO OPERATE 1 2 CHANGE IN CONDITIONS TO OPERATE 3 4 7 APPROVED CONSTRUCTION 5 6 WRITTEN MONITORING PROCEDURES 7 8� APPROVED MONITORING SYSTEM 9 10 MONITORING SYSTEM 11 w✓I (C - APPROVED MONITOR FREQUENCY 13 17 14 MONITORING RECORDS MAINTAINED 15 16 ACCESS CASING SECURED 17 18 PIPING 19 20 INVENTORY RECONCILIATION 21 22 TANK GAUGING 23 24 - APPROVED RESPONSE PLAN 25 26 UNAUTHORIZED RELEASE OCCURRENCE 27 28 SAMPLING 29 130 APPROVED TANK REPAIRS 31 32 UNAUTHORIZED RELEASES REPORTED 33 34� SAFETY 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 43 OWNER/OPERATOR MONITORING 44 45 PERMANENT TANK CLOSURE REMOVAL OF RESIDUAL MATERIALS 46 47 PIPING 48 49 FLAMMABLE VAPORS REMOVED 50 UNAUTHORIZED RELEASE 51 52� SAMPLING 53 54 IMPROPER ABANDONMENT 55 156� THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS (MUST MARK ONE) FOLLOWS: _ y P c C� 57 58 59 ` MAJOR MNOR NO ❑ ❑ VIOL. VIIOL. VIOL. RECEIVED BY: OFFICE: INSPIv �---' '�k' ?14t�4 TITLE: PHONE: BECK: HUT-3 ORIGIN L 5/88 0M