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UNDERGROI.'k '%,;TANK PROGRAM OFFICIAL INS, `""TION REPORT s AN J SOAQUIN HEATH DISTRIC f 1601 E. HAZELTON ,v COUNTY NAME, STOCKTON, CA 95205 COUNTY # PHONE NO. 468-3423 SITE NAME: 1 - INSPECTION DATE: SITE ADDRESS: CITY/STATE/ZIP CHANGES SITE/OWNER/PERMIT? YES NEF TANK TANK TANK TANK FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER i c/ PER# 2Z'f3--pY PER# iP PER# PER# / f"Gr�'tvd AA Y.3 — O/ EXP.DATE EXP.DATE EXP.DATE EXP.DATE OPERATIONAL TANK ITANK CONTENTS MAJOR MINOR PERMIT TO OPERATE i 2 ik CHANGE IN CONDITIONS O S TO OPERATE 3 - 4 APPROVED CONSTRUCTION 5 6 — WRITTEN MONITORING PROCEDURES 7 8 -- APPROVED MONITORING SYSTEM9 10 13 MONITORING SYSTEM 11 12 APPROVED MONITOR FREQUENCY _ 13 14 MONITORING RECORDS MAINTAINED 15 16 q - ACCESS CASING SECURED _ 17 18 — I I PIPING 19 20 INVENTORY RECONCILIATION 21 22 TANK GAUGING 23 24 APPROVED RESPONSE PLAN 25 26 UNAUTHORIZED RELEASE OCCURRENCE 27 28 II SAMPLING 29 30 �, - - ----— APPROVED TANK REPAIRS 31 32 '— UNAUTHORIZED RELEASES REPORTED 33 34 - SAFETY HAZARD 35 36 CONDITIONS ABATED . 37 TEMPORARY TANK CLOSURE ' ' � x5 r �; A. ,} "t REMOVAL OF RESIDUAL 38 39 ;# FLAMMABLE VAPORS REMOVED 40 -- ACCESS LOCATIONS SEALED 41 42 � -- i POWER DISCONNECTED 43 OWNER/OPERATO N 44 45 ERMANENT TANK CLOSURE � ", -� rt s .57 t g � : REMOVA ESIDUAL 46 47 PIPING 48 49 — FLAMMABLE VAPORS REMOVED 50 • ;i, UNAUTHORIZED RELEASE 51 52 — SAMPLING 53 54 -- --- - i: IMPROPER ABANDONMENT 55 56 --� I - ------- -- -_ THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: e2 1W -42 n 12 K 58 MAJOR 57 MINOR NO VIOL. ❑ VIOL ❑ VIOL i'• :i i1 OFFICE: INSP:4�2�.,,Vl RECEIVED BY: h TITLE: �,GS PHONE: BECK: HUT-3 ORIGINAL ©r - - r