Laserfiche WebLink
UNDERGROUP TANK PROGRAM OFFICIAL INSP' TION REPORT <br /> .USAN JOAQUIN HEALTH DISTRICT- - <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKT95205 <br /> NO. 46 <br /> PHONE NO. 466-3423 COUNTY # <br /> SITE NAME: INSPECTION DATE: f7 <br /> SITE ADDRESS: Isel 7 CITY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? S N TANK TANK �L TANK Q,? TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COM TE <br /> � PER# PER# PER# PER# <br /> EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK WIK CONre <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 15 16 <br /> ACCESS CASING SECURED 17 18 <br /> PIPING 19 20 _ <br /> INVENTORY RECONCILIATION 21 22 _ <br /> TANK GAUGING 23 124 <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 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 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 MARK EMS R PRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS <br /> 57 58 59 <br /> MAJOR MINOR NO <br /> VIOL ❑ VIOL ❑ VIOL <br /> OFFIc � INSP: n n RECE ED BY: <br /> TITLE: PHONE: RECK: <br /> HUT-3 ORIGINAL <br />