REMOVAL_1996 - Laserfiche WebLink

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-.NDERGROUND TANK OFFICIAL INSPECTIOWWtPORT SAN JOAQUIN PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION 445 N.San Joaquin Street COUNTY NAME Mailing Address: P.O.Box 388 U�N Stmicto.8A 95201-0388 420 CONNif # 9 SITE NAME: #Z� / `y INSPECTION DATE: /09-87 7j Ing SITE ADDRESS: CITY/STATE/ZIP G> CHANGES SITE/OWNER"/1PERMIT? YES NO NK ✓Y� FORM AAND/OR B SUBMITTED? TANK d Z TANK 3 TANK COMPUTER COMPUTER COMPUTER COMPUTER TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER PER# PER # PER# 105(. PER# EXP.DATE EXP.DATE EXP.DATE EXP.DATE OPERATIONAL TANK mNK coNreNTs MAJOR MINOR PERMIT TO OPERATE 1 2 CHANGE IN CONDITIONS TO OPERATE 3 4 APPROVED CONSTRUCTION 5 6 WRITTEN MONITORING PROCEDURES 7 8 APPROVED MONITORING SYSTEM 9 10 MONITORING SYSTEM 11 12 _.._ APPROVED MONITOR FREQUENCY 13 14 MONITORING RECORDS MAINTAINED 15 16 ACCESS CASING SECURED 17 18 PIPING 19 20 INVENTORY RECONCILIATION 21 22 TANK GAUGING 23 24 APPROVED RESPONSE PLAN 25 26 - UNAUTHORIZED RELEASE OCCURRENCE 27 28 SAMPLING 29 30 APPROVED TANK REPAIRS 31 32 UNAUTHORIZED RELEASES REPORTED 33 34 SAFETY HAZARD 35 CONDITIONS ABATED 37 TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 3g 3g FLAMMABLE VAPORS REMOVED 40 ACCESS LOCATIONS SEALED 41 42 POWER DISCONNECTED 43 OWNER/OPERATOR ING44 45 PERMANENT TANK CLOSURE REMO V1 '17 S 46 47 PIPING 48 49 FLAMMABLE VAPORS REMOVED 50 UNAUTHORIZED RELEASE 51 52 SAMPLING 53y1 IMPROPER ABANDONMENT 55 56 THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: MAJO 57 58 59 R NO VIOL, ❑ VIOLL..R ❑ VIOL❑ OFFICE: INSP: RECEIVED BY: TITLE: PHONE: RECK: HUT-3 White-Original Yellow.Owner'a Copy Pink-File Coov -.-.