COMPLIANCE INFO 1987-1997 - Laserfiche WebLink

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U&GROUND TANK OFFICIAL INSPECTION R*T SAN JOAQUIN PUBLIC HEALTH SERVICES ENVIRON IEE ML Hber A AL�Tq DIVISION Mailing AddmS:P.O.BOX 388 Stockton, COUNTY # COUNTY MIME eA952 1 0388 INSPECTION DATE: V/� SITE NAME: SITE ADDRESS: 4-C A✓E. CITY/STATE/ZIP Go Gp��G9/952S�d 5-"500oo w CHANGES SITE/OWNER/PERMIT? YES NO TANK f/ TANK TANK at TANK FORM A AND/OR B SUBMITTED? COMPUTER COMPUTE/RZr� NUOMBERER/z� COMBERER NUMBER �7-u�" NUMBER TYPE OF INSPE TION SITE COMPUTER+Y PER or PER# PER A PER a EXP DALE EXP DATE EXP.DATE EXP.DATE OPERATIONALTANK mmcoRlER15 +. ;ry* 11X ,, MAJ R MINOfl + PERMIT TO OPERATE 2 CHANGE IN CONDITIONS TO OPERATE 3 4 APPROVED CONSTRUCTION 5 6 _ WRITTEN MONITORING PROCEDURES 8 APPROVED MONITORING SYSI EM 9 10 MONITORING SYSTEM 11 12 _ APPROVED MONITOR FREQUENCY 13 14 MONITORING RECORDS MAINTAINED 15 I6 ACCESS CASING SECURED 17 IB PIPING 19 20 INVENTORY RECONCILIATION IV22 TANK GAUGING23 24 _ . .. .. APPROVED RESPONSE PLAN 25 26 I _ UNAUTHORIZED RELEASE OCCURRENCE 27 26 SAMPLING APPROVED TANK REPAIRS 31 32 UNAUTHORIZED RELEASES REPORTED 33 34 SAFETY IIAZARD CONDITIONS ABATED 37 TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL W383t9FLAMMABLE VAP ORS REMOVED ACCESS LOCATIONS SEALED POWER DISCONNECTED OWNER/OPERATOR MONITORING �+ PERMANENT TANK CLOSURE & REMOVAL OF RESIDUAL MATERIALS 46 47 PIPING 48 49 FLAMMABLE VAPORS REMOVED 50 UNAUTHORIZED RELEASE 51 52 SAMPLING 53 54 IMPROPER ABANDONMENT 55 56 THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: 58 59 MAJOR 57 MINOR NO VOL.F-1VIOL. VIOL. OFFICE: INSP: EREC � BY: — L� TITLE: PHON . RECK � � l�/ 1 IUT-3 While Original Vellow-Owner's COPY Pink-File COPV PHS 178 (4/96)