Laserfiche WebLink
UNDERGROUJOTANK PROGRAM OFFICIAL INS ION REPORT <br /> SAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY # <br /> PHONE NO. 468-3423 <br /> SITE NAME: ��. INSPECTION DATE: I O <br /> SITE ADDRESS: ,�233 CITY/STATE/ZIP-r' <br /> CHANGES SITE/OWNER/PERMIT? YES O" TANK -I-J'Z_l TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? L- COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYP OF INSPECTION SITE COMPUTER# <br /> � PER # PER # PER # PER# <br /> 1 I <br /> E_XP._DAT E EXP.DATE EXP. DAFE EXP. DATE <br /> OPERATIONAL TANK TANK CONTENTS <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 24 <br /> APPROVED RESPONSE PLAN %3334 <br /> UNAUTHORIZED RELEASE OCCURRENCE <br /> SAMPLING <br /> APPROVED TANK REPAIRS <br /> UNAUTHORIZED RELEASES REPORTED SAFETY HAZARD CONDITIONS ABATED <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL W43 <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED <br /> POWER DISCONNECTED OWNER/OPERATOR MONITORING <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 VIOLAT�UST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> 57 58 59 <br /> MAJOR MINOR NO <br /> VIOL ❑ VIOL [A VIOL. <br /> OFFICE: INSR �656- 7:f RECEIVED BY: <br /> TITLE: '1 PHONE: BECK: <br /> I�"ArtGl.fti.� <br /> 1UT-3 ORIGINAL 5/88 OM <br />