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UNDERGROUI TANK PROGRAM OFFICIAL INSPr' TION REPORT <br /> `^SAN JOAQUIN HEALTH DISTRICT+w <br /> 1601 E. HAZELTON AVE. <br /> S STOCKTON, CA 95205 COUNTY # 39 <br /> COUNTY NAME <br /> JpQ tu,f) PHONE NO. 468-3423 <br /> SITE NAME: r w ���o INSPECTION DATE: <br /> SITE ADDRESS: So KtW[- CITY/STATE/ZIP CA q,507 ,9 5 <br /> CHANGES SITE/OWNER/PERMIT? YES N TANK I TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTIONSITE CO/M,[P,UpTER# PER# PER# PER# PER # <br /> � b n e I`�Vv EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK MAJORIN MI NOR <br /> MAJOR MINOR <br /> PERMIT TO OPERATE 1 2 <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 <br /> APPROVED CONSTRUCTION 5 6 <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 15X 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 <br /> SAFETY HAZARD 35 36 _ <br /> CONDITIONS ABATED V, 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 4142 <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 BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> 57 58 59 <br /> lvllfm140 <br /> VIOL. ® VIOLS ❑ VOL❑ <br /> OFFICE: INSP. R&OEWE�nwix- 20 <br /> �(J <br /> P-3�a 92 Mroor7 S�Ck�m (A lSla <br /> TITLE: rJ' cls, PHONE: BECK: <br /> -AUT-3 ORIGINAL 5/88 OO m <br />