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WEE NAME: ^ COUNTY NAME 0 S•1 67 J <br /> INSPECTION DATE: s �� <br /> SITE ADDRESS: <br /> CrrY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMR? YES TANK TANK <br /> MFR/PERM(T SUBMITTED LANK TANK <br /> SREOOMPT!(ER• P / D• 6)2-- D <br /> ESI PER 0 PER <br /> EXP DREPER <br /> OPERATIONAL TANK MAJ. MIN. EXP.DATE EXP.DRE Exp DAIS <br /> PERMR TO OPERATE 1 2 <br /> CHANGE N CONDITIONS TO OPERATE J 4 <br /> APPROVED CONSTRUCTION 5 e <br /> WR TTEN MON(MF NOPROCEDURES 7 E <br /> APPigVED MON(TORpq SYSTEM B 10 <br /> MONTIORNO SYSTEM 11 12 <br /> APPROVED MONROR FREQUENCY iJ 14 <br /> MOMibRNO RECORDS W*nAINEO 15 18 <br /> 14 ACCESS CASH SECURED 17 18 <br /> ` P1PN0 <br /> INVENTORY RECONCIUAT)ON 16 20 <br /> TAM GAUGING 21' 22 <br /> 2J 24 <br /> APPROVED RESPONSE PUN 25 28 <br /> UNAUTHORIZED RELEASE OCCURRENCE 28 <br /> NK <br /> SAMPLING 2 277 JO <br /> APPROVED TAREPAIRS Jt 32 <br /> UNAUTHORIZED RELEASES REPORTED 37 34 <br /> SAFETY FMZARO 35. 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIOUAI <br /> 38. 39 <br /> FLAMMABLE VAPORS REMOVED 400 <br /> ACCESS LOCATIONS SEALED 41! 42 <br /> POWER DISCOWIECTED 43 <br /> OWNER/OPERATOR MONITORING 44, 45; <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 4f 1 47 <br /> PIPING <br /> 48 49 <br /> 1, <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING SJ 54 <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED ITEMS REPRESENT VKTIAIIONS MUST E CORRECTED AS <br /> YSTEM STATUS IMUST M O-O+EI <br /> FOLLOWS: o �Ck <br /> _ SI <br /> MI <br /> ❑ NOR 58 NO <br /> VIOL <br /> VIOL ❑ VIOL <br /> I61*IN LOCAL HEALTH DISTRI( NSf-. RECEP/EOBY: <br /> )ST OFFICC BOX 2009 <br /> )CKTON. CALIF. 95201 _��-- l <br /> V: ENVIRON. HEALTH TITLE'Si" "LGt bt----A/n ' "SCK <br /> "'pm. o- <br />