Laserfiche WebLink
UN*GROUND TANK OFFICIAL INSPECTION RIOT <br /> SAN JOAQUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 445 N.San Joaquin Street <br /> Meiling Address: P.O.Box 388 <br /> COUNTY NAME Stockton,CA 95201-0388 <br /> 488-3420 COUNTY # <br /> SITE NAME: <br /> INSPECTION DATE: Z 9 <br /> SITE ADDRESS: OSCITY/STATE/ZIP / <br /> CHANGES SITE/OWNER/PERMIT? YES /NO TANK TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER <br /> PER# PER# PER# PER# <br /> EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATI NAL TANK M34 <br /> PERMIT TO OPERATE <br /> CHANGE IN CONDITIONS TO OPERATEAPPROVED CONSTRUCTIONWRITTEN MONITORING PROCEDURESAPPROVED MONITORING SYSTEM <br /> __.._..__._......._.__-...__._ -_.._.___._._..__... <br /> MONITORING SYSTEM 11 12 <br /> APPROVED MONITOR FREQUENCY 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ACCESS CASING SECURED17 <br /> 18 <br /> PIPING 19 20 <br /> INVENTORY RECONCILIATION 21 '52— <br /> TANK GAUGIN <br /> 2TANKGAUGING — - - <br /> 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 RELEASES REPORTED 33 34 <br /> TY HAZARD 35 36 <br /> CONDITIONS ABATED W7 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL W4445 <br /> ............ ... <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED <br /> POWER DISCONNECTED <br /> OWNER/OPERATOR MONITORING <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 /> SYSTEM STATUS(MUST MARK ONE) THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> FOLLOWS: CpW <br /> 57 58 59 <br /> No <br /> VIOLR ❑ VIOL. ❑ VOL.❑ r <br /> OFFICE: INS / RE ED <br /> TITLE: PHONE: - RECK: <br />