Laserfiche WebLink
UNDERGROI' -TANK PROGRAM OFFICIAL INSP� TION REPORT <br /> AN JOAQUIN HEALTH DISTRICI <br /> 1601 E. HAZELTON AVE. <br /> COUUY NAMESTOCKTON, CA 95205 COUNTY # <br /> PHONE NO. 466-3423 <br /> SITE NAME: -pE a INSPECTION DATE: I fzgkl <br /> SITE ADDRESS: 3� CITY/STATE/ZIPrp� ZO� <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANk 1 TANK Z TANK TANK/ <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER <br /> PER# PER# PER PER# <br /> EXP.DATE EXP.DATE EX .DATE EXP.DATE <br /> NTS <br /> OPERATIONAL TANK MAJ0OR MIlNOR__ N R N0R <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 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 /> SAMPUNG 29 30 <br /> APPROVED TANK REPAIRS 31 32 <br /> UNAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD 35 36 _ <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL &3839FLAMMABLE VAPORS REMOVED ACCESS LOCATIONS SEALED 42POWER DISCONNECTED 43OWNER/OPERATOR MONITORING 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 /> MAJOR 57 MINOR 58 NO 59 <br /> VIOL WJ VIOL. ❑ VIOL❑ <br /> OFFICE: INSP: Q r I • X <br /> BY: <br /> TITLE:W S /'L PHONE: RECK: <br /> HUT-3 ORIGINAL <br />