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UNDERGROUf TANK PROGRAM OFFICIAL INSP TION REPORT <br />SAN JOAQUIN HEALTH DISTRIC <br />1601 E. HAZELTON AVE. <br />:OUNTY NAME STOCKTON, CA 95205 COUNTY # <br />PHONE NO. 468-3423 <br />SITE NAME: f a \ <br />3 4 <br />47 <br />INSPECTION DATE: <br />SITE ADDRESS: <br />APPROVED CONSTRUCTION <br />CITY/STATE/ZIP <br />FLAMMABLE VAPORS REMOVED <br />js-(Z to <br />WRITTEN MONITORING PROCEDURES <br />7 8 <br />scq <br />O -I <br />CHANGES SITE/OWNER/PERMIT? YEO <br />NO <br />TANK <br />TANK <br />TANK <br />TANK <br />FORM A AND/OR B SUBMITTED? <br />156 <br />COMPUTER <br />COMPUTER <br />COMPUTER <br />13 Y, 14 <br />COMPUTER <br />NUMBER <br />NUMBER <br />NUMBER <br />NUMBER <br />TYA OF INSPECTION <br />SITE COMPUTER # <br />PER # <br />PER # <br />PER # <br />PER # <br />V'ou A4 A e_ IJ U v I 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 <br />3 4 <br />47 <br />PIPING <br />APPROVED CONSTRUCTION <br />5 6 <br />FLAMMABLE VAPORS REMOVED <br />50 <br />WRITTEN MONITORING PROCEDURES <br />7 8 <br />m '! <br />51 <br />52 <br />APPROVED MONITORING SYSTEM <br />9 10�. <br />53 <br />54 <br />MONITORING SYSTEM <br />11 12 <br />156 <br />_._ <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />FOLLOWS: <br />APPROVED MONITOR FREQUENCY <br />13 Y, 14 <br />SYSTEM STATUS (MUST MARK ONE) <br />MONITORING RECORDS MAINTAINED <br />15 16 <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 />- <br />APPROVED TANK REPAIRS <br />31 32 <br />UNAUTHORIZED RELEASES REPORTED <br />33 34 <br />SAFETY HAZARD <br />35 36 <br />• • • �' <br />effi <br />• • ■ ®® VIII <br />OF <br />r � � <br />• <br />L A ER IAL <br />46 <br />47 <br />PIPING <br />48 <br />49 <br />FLAMMABLE VAPORS REMOVED <br />50 <br />m. <br />UNAUTHORIZED RELEASE <br />51 <br />52 <br />SAMPLING <br />53 <br />54 <br />IMPROPER ABANDONMENT <br />155 <br />156 <br />_._ <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />FOLLOWS: <br />SYSTEM STATUS (MUST MARK ONE) <br />MAJOR MINOR 58 NO 59 <br />VIOL. VIOL. ❑ VIOL. ❑ <br />A,.t a/ t v' i <br />5e L)S S %fc t <br />OFFICE: INSP: RECEIVED BY: <br />Yx2 <br />A."'Lw <br />TITLE: es PHONE: � RE K: <br />HUT -3 ORIGINAL 5/88 <br />