COMPLIANCE INFO_1994-2001 - Laserfiche WebLink

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AGROUND TANK OFFICIAL INSPECTION RORT SAN JOAQUIN PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION 445 N. San Joaquin Street Mailing Address: P.O. Box 388 COUNTY NAME Stockton, CA 95201-0388 COU TY 468.3420 SITE NAME: INSPECTION DATE _/ SITE ADDRESS:/ / CITY/STATE/ZIP / .� nn - CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK TANK FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER TYPE OF INSPECTION SITE COMPUTER # NUMBER NUMBER NUMBER NUMBER PER # PER # PER # PER # EXP. DATE EXP. DATE EXP. DATE EXP. DATE OPERATIONAL TANK PERMIT TO OPERATE TANK CONTENTS OR MINOR 1 2 s g` y CHANGE IN CONDITIONS TO OPERATE REMOVAL OF RESIDUAL MATERIALS 46 47 3 4 APPROVED CONSTRUCTION 5 6 WRITTEN MONITORING PROCEDURES 7 8 _. APPROVED MONITORING SYSTEM FLAMMABLE VAPORS REMOVED 50 9 10 MONITORING SYSTEM 11 12 APPROVED MONITOR FREQUENCY 13 14 MONITORING RECORDS MAINTAINED SAMPLING 53 54 15 16 ACCESS CASING SECURED 17 18 PIPING 19 20 INVENTORY RECONCILIATION 21 22 TANK GAUGING 23 24 NO 59 VIOL. APPROVED RESPONSE PLAN 25 26 -- ------ �„_.___ . ................_ . ... . ._.._- UNAUTHORIZED RELEASE OCCURRENCE 27 28 SAMPLING 29 30 OFFICE: rl a G`DX/ , APPROVED TANK REPAIRS 31 132 TITLE: S (—> PHONE: UNAUTHORIZED RELEASES REPORTED 33 134 SAFETY HAZARD 35 36 CONDITIONS ABATED 37 TEMPORARY TANK CLOSURE r a REMOVAL OF RESIDUAL 38 39 FLAMMABLE VAPORS REMOVED 40 ACCESS LOCATIONS SEALED 41 42 POWER DISCONNECTED 43 OWNER/OPERATOR MONITORING 44 45 T TANK CLOSURE N' E.” 1 Y "Z REMOVAL OF RESIDUAL MATERIALS 46 47 PIPING 48 49 _. FLAMMABLE VAPORS REMOVED 50 UNAUTHORIZED RELEASE 51 52 SAMPLING 53 54 IMPROPER ABANDONMENT 155 156 THE MARKED ITEMS REPRESENT VIOLATIONS FOLLOWS: AND MUST BE CORRECTED AS SYSTEM STATUS (MUST MARK ONE) MAJOR 57 MINOR 58 VIOL. ❑ VIOL. ❑ NO 59 VIOL. -- OFFICE: rl a G`DX/ , INSP: � REC IV Y: TITLE: S (—> PHONE: BECK: NUT -3 White -Original Yellow -Owner's Copy Pink - File CooH