REMOVAL_1992 - Laserfiche WebLink

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UNDERGROUND TANK PROGRAM OFFICIAL INSPEr—ION ,.AN JOAQUIN HEALTH DISTRICT 1601 E. HAZELTON AVE. STOCKTON, CA 95205 COUNTY NAME PHnNF NO 4en-3423 REPORT COUNTY # A� oF3 SITE NAME: D D —T INSPECTION DATE: SITE ADDRESS: 255600 C AAlsIviAril CITY/STATE/ZIP CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK TANK FORM A AND/OR B SUBMITTED? COMPUTE COMPUTER COMPUTER COMPUTER NUMBER NUMBER NUMBER # TYPE OF INSPECTION SITE COMPUT�,FL,R,x 1 — J V PER # �p EXP. DATIj- 6.,pCLNUMBER A` 0 PER # DATE PER # EXP. DATE PER # EXP. DATE OPERATIONAL TANK TANK CONTENM MAJOR I MINOR PERMIT TO OPERATE 1 2 CHANGE IN CONDITIONS TO OPERATE 3 4 APPROVED CONSTRUCTION 5 6 _ WRITTEN MONITORING PROCEDURES 7 18 1_ APPROVED MONITORING SYSTEM 9 10 MONITORING SYSTEM 11 112 APPROVED MONITOR FREQUENCY 13 114 MONITORING RECORDS MAINTAINED 15 16 ACCESS CASING SECURED 1718 PIPING 19 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 SAFETY HAZARD 35 36 CONDITIONS ABATED 37 TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 38 39 FLAMMABLE VAPORS REMOVED 140 ACCESS LOCATIONS SEALED 141 142 POWER DISCONNECTED 43 OWNER/OPERATOR MONITORING 44 45 PERMANENT TANK CLOSURE REMOVAL OF RESIDUAL MATERIALS 46 47 PIPING 48 49 _ FLAMMABLE VAPORS REMOVED 50 UNAUTHORIZED RELEASE 51 52 _ SAMPLING 53 54 IMPROPER ABANDONMENT 55 56 THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS (MUST MARK ONE) FOLLOWS: L. 57 58 5 MAJOR MINOR NO ❑ ❑ VIOL VIOL. VIOLQRA OFFICE: INS P/ RECEIVED BY: RECK: TITLE:PHONE: HUT -3 ORIGINAL sim u