Laserfiche WebLink
UNDERGROUW TANK PROGRAM OFFICIAL INSPE"90N REPORT <br /> �. AN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY <br /> PHONE NO. 468-3423 <br /> SITE NAME: D F-fr,p*ISR P e- QrT -TXf l-C INSPECTION DATE:At/41!!/'fQ <br /> SITE ADDRESS: Zc S-00 GH'?v4'5A4" CITY/STATE/ZIP / w ?57 76 <br /> CHANGORM AE AND/OR B SUBMITTED? <br /> YES NO COMPUTER TANK COMPUTER COMPUT 44 CQMPUTER <br /> TYPE OF INSPECTION SITE COMPUpT/E <br /> ��R# PER#4000r4NUMBER NUMBER NUMBER NUMBER <br /> 15- D EXP.DATE �ij EXP.DATE EXP.DATED 00 PXP.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 8 <br /> __... <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 I <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 /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BEC RRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: 3 <br /> 57 59 <br /> MAJOR MINOR 58 NO <br /> VIOL. ❑ VIOL. ❑ VIOL <br /> OFFICE: INSP: RECEyIVEC3BY� <br /> TITLE: PHONE: 10 REEOOK: �t <br /> HUT-3 ORIGINAL siee OM <br />