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Imp COUNTY NAME ♦ <br /> SITE NAME: 1 Tm Q / INSPECTION DATE: SI�� <br /> SITE ADDRESS: f � / / j / CITY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK TANK <br /> MFR/PERMIT SUBMITTED Of ,, ID 0 ID ID• <br /> TYPE OF NWECTION SRE COMPUTER♦ PER• PER 0 PER ♦ PER • <br /> EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL.TANK MAJ MIN. <br /> PEP"T TO OPERATE 12.9- <br /> 2 <br /> CHANGE N CONDITIONS TO OPERATE <br /> APPROVED CONSTRUCTION 8 <br /> WRITTEN MONITORING PROCEDURES 8 <br /> -APPROVED MONITORING SYSTEM 10 <br /> MONITORING SYSTEM 12 <br /> APPROVED MONITOR FREQUENCY 14 <br /> MONRORNO RECORDS MANTANED 18 <br /> ACCESS CASINO SECURED 18 <br /> PIPING 20 <br /> INVENTORY RECONCILIATION 22 <br /> TANK GAUGING 24 <br /> APPROVED RESPP,�SE PLAN 26 <br /> UNAUTHORIZED RELEASE OCCURRENCE 26 _ <br /> SAMPLING JOAPPROVED TANK REPAIRS J21 <br /> UNAUTHORIZED RELEASES REPORTED J4SAFETY HAZARO J6COIJIXTIONS ABATED <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL Nt7 <br /> FLAMMABLE VAPORS RE MOUE D <br /> ACCESS LOCATIONS SEALED <br /> POWER DISCONNECTED <br /> OYVNER/OPERATOR MONITORING 45i <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 461 A7 <br /> PIPING 48 49 <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 5J 54 <br /> IMPROPER ABANDONMENT SS 58 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONEI FOLLOWS: I ,- 350 <br /> MAJOR57 58 59 <br /> MfNOANO <br /> VIOL ❑ VIOL ❑ VIOL❑ <br /> S RyLOCAL HEALTH DISTRI NSP RECEIVED BY: <br /> POST OST OFFIC[ BOX 2009 ' <br /> STOCKTON. CALIF. 95201 <br /> N: ENVIRON. HEALTH PONE "EC" <br />