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UI JROUND TANK OFFICIAL INSPECTION RIC .r <br /> SAN JOAQUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 445 N.San Joaquin Street <br /> Mailing Address: P.O.Box 388 <br /> COUNTY NAME Stockton,CA 95201-0388 COUNTY # <br /> _ 468-3420 _� <br /> SITE NAME: FIRIANI& NY, C F, INSPECTION DATE: I -7 l' <br /> f! RoD <br /> SITE ADDRESS: /^/! CT 's# J L _ )�G CITY/STATE/ZIP 74 <br /> � �q <br /> CHANGES SITE/OWNER PERMIT? YES NO TANK F� TANK ''fes TANK TANK 3 <br /> FORM A AND/OR B SUBMITTED? COMPUTERCOMPUTE COMPUTER COMPUTER <br /> D <br /> TYPE OF INSPE TION SITE COMPUTER# NUMBE ,,i NUMBER ooa NUMBER VC700 NUMBER <br /> I O EXP.DATE PER # 4 PER# PER# <br /> MAiMiV' EXP.DATE EXP.DATE ! V XP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR I 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 <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 34 <br /> SAFETY HAZARD 35 36 <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 <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 53 54 <br /> IMPROPER ABANDONMENT 55 56 <br /> !!q] <br /> THE MARKED IT REPRESENT VIOLATIONS AND MUST BE CO E TED <br /> SYSTEM STATUS(MUST MARK ONE) FOLL WS: <br /> MAJOR 57 MINOR 58 NO 59 f <br /> VIOL. ❑ VIOL. ❑ VIOL. <br /> 171 <br /> OFFICE: INSP.kV' RECEIVED <br /> / \ r <br /> _v eTITLE: PHON - 3-- <br /> BECK:. �3 <br /> HUT-3 <br /> White-Original Yellow-Owner's Copy Pink-File Copv 5/88 0 M <br />