Laserfiche WebLink
UNDERGROUP'^ TANK PROGRAM OFFICIAL INSPr- "ON REPORT <br />,,, N JOAQUIN HEALTH DISTRICT�.� <br />1601 E. HAZELTON AVE. <br />STOCKTON, CA 95205 COUNTY # 3 y <br />WUNI I NAME <br />PHONE NO. 468-3423 <br />SITE NAME: <br />�w 0- Ph�o / INSPECTION DATE: /o-/� -y <br />SITE ADDRESS: 3 <br />C�/Y��" <br />` Gf/(/ C' CITY/ TATE/ZIP <br />CHANGES SITE/OWNER/PERMIT? YES <br />NO <br />TANK TANK <br />COMPUTER <br />tNUMBER <br />FORM AAND/OR B SUBMITTED? <br />COMPUTER COMPUTER <br />NUMBEq�1 QDO NUMBER NUMBER <br />TYPE F INSPECTION SITE COOMPUTER # <br />PER #LPER # PER # <br />i4hjj �wS (O <br />EXP. DATE EXP. DATE EXP. DATE <br />OPERATIONAL TANK <br />TANKNOR <br />OR <br />MAJOR <br />MI <br />MI <br />PERMIT TO OPERATE <br />1 <br />2 <br />CHANGE IN CONDITIONS TO OPERATE <br />APPROVED CONSTRUCTION <br />5 <br />6 <br />--- <br />WRITTEN MONITORING PROCEDURES <br />APPROVED MONITORING SYSTEM <br />MONITORING SYSTEM <br />- <br />APPROVED MONITOR FREQUENCY <br />13 <br />14 <br />MONITORING RECORDS MAINTAINED <br />15 <br />16 <br />- - - <br />ACCESS CASING SECURED <br />17 <br />18 <br />PIPING <br />19 <br />20 <br />_-- <br />INVENTORY RECONCILIATION <br />21 <br />22 <br />TANK GAUGING <br />23 <br />24 <br />APPROVED RESPONSE PLAN <br />25 <br />26 <br />_ <br />UNAUTHORIZED RELEASE OCCURRENCE <br />27 <br />28 <br />SAMPLING <br />29 <br />30 <br />APPROVED TANK REPAIRS <br />31 <br />32 <br />UNAUTHORIZED RELEASES REPORTED <br />33 <br />34 <br />- <br />SAFETY HAZARD <br />35 <br />36 <br />_ <br />CONDITIONS ABATED <br />37 <br />TEMPORARY TANK CLOSURE <br />I <br />REMOVAL OF RESIDUAL <br />._ _ _ __ _ _ <br />FLAMMABLE VAPORS REMOVED <br />_ _ --77 ___ - _ - __ <br />ACCESS LOCATIONS SEALED <br />w444.5 <br />POWER DISCONNECTED <br />OWNER/OPERATOR MONITORING <br />_ <br />PERMANENT TANK CLOSURE <br />REMOVAL OF RESIDUAL MATERIALS <br />46 <br />47 <br />PIPING <br />48 <br />49 <br />FLAMMABLE VAPORS REMOVED <br />50 <br />MR_ <br />UNAUTHORIZED RELEASE <br />51 <br />52 <br />_ <br />SAMPLING <br />53 <br />54 <br />IMPROPER ABANDONMENT <br />55 <br />56 <br />THE MARK NT VIOLATIONS AND MUST B CORRECTED AS <br />SYSTEM STATUS (MUST MARK ONE) <br />// <br />FOLL b !n4 d rGG(Sr v� <br />57 58 <br />MAJOR MINOR NO <br />❑ ❑ <br />VIOL VIOL VIOL09 <br />✓'« <br />OFFICE: <br />INSP: <br />RECE,IXED� <br />PHON <br />RECK: <br />TITLE: <br />HUT -3 ORIGINAL 5/M <br />