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UNDERGROU K PROGRAM OFFICIAL INSP REPORT <br /> JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 <br /> PHONE NO. 468 3423 COUNTY # J <br /> SITE NAME: / L. INSPECTION DATE: (79� <br /> SITE ADDRESS: © / /d 1r LlN /4E Y/STATE/ZI (�(� q,c 7/ <br /> CHANGES SITE/OWNER/P RMIT? YES NO TANK / T K 2� TANK TANK / v <br /> FORM A AND/OR B SUBMITTED? COMPUTER OMPUTE COMPUTER COMPUTER <br /> TYPE OF IJ�PECTION SITE COMPUTER# NUMBER C� NUMBER 'S NUMBER NUMBER <br /> PER# ,/ PER # PER# PER # <br /> EXP.DA - EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR MINOR <br /> PERMIT TO OPERATE 1 2 <br /> _._.__.. _._- <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 20 <br /> INVENTORY RECONCILIATION 21 22 - -- <br /> TANK GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 25 26 <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 26 <br /> SAMPLING P9 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 DISCONNECTED43 -----"`-"- -- _ - <br /> OWNER/OPERATOR MONITORING 44 45777-777-777�- <br /> - <br /> PERMANENT TANK CLOSURE <br /> „.-'.. <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 MS REPRESENT VIOL4TIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> 58 <br /> MAJOR 57 MINOR NO 59 <br /> VIOL. VIOL. ❑ VIOL❑ <br /> OFFICE: INSP: RECEIVED B <br /> O b / TITLE: S� s PHo 3 ECK: <br /> HUT-3 D� to ORIGINAL <br /> siaa 0, <br />