Laserfiche WebLink
UNDERGROU' TANK PROGRAM OFFICIAL INSP' TION REPORT <br /> SAN JOAQUIN HEALTH DISTRICIy <br /> 1601 E. HAZELTON AVE. COUMT� # <br /> n N I n STOCKTOCA 95205 <br /> COUNTIIUME WI1 v Q PHONE NO. 468-3423 <br /> SITE NAME: bCV�� �� J ' INSPECTION DATE: <br /> SITE ADDRESS: l�JI00 3 CITY/STATE/ZIP / <br /> CHANGES SITE/OWNER/PERMIT? Y S TANK 0 l TANK (YL TANK 03 TANK ay <br /> FORM A AND/OR B SUBMITTED?1� flCOMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER U/QK NUMBER /ok NUMBER Vi � _ NUMBER ,2,CUQ.[.�Q' <br /> T�Fn OF INSPECTION SITE COMPUTER# EXP.DATE p G o EXP.DAT PER <br /> XDATE IY6.3�%(1 EXP.DAT J!E <br /> OPERATIONAL TANK K R I N R <br /> MAJOR MINOR <br /> PERMIT TO OPERATE 1 2 - <br /> CHANGE IN CONDITIONS TO OPERATE 3 —4 <br /> ----- <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 19 120 1 _ <br /> INVENTORY RECONCILIATION 21 122 <br /> TANK GAUGING 23 124 1 <br /> APPROVED RESPONSE PLAN 25 126 <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 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED M 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 /> MAJOR 57 58 <br /> MINOR NO 59 <br /> VIOL ❑ VIOL ❑ VIOL <br /> OFFICE: INSP: RECEIVED BY: <br /> TITLE: 1� <CL PHONE: RECK: <br /> HUT-3 /` ORIGINAL c7 51� O' <br />