Laserfiche WebLink
UNDERGROUM&TANK PROGRAM OFFICIAL INSPf&TION REPORT <br /> AN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> STOCKTON, CA 95205 COUNTY # <br /> COUNTY NAMEPHONE NO. 468-3423 <br /> SITE NAME: <br /> INSPECTION DATE: <br /> �-�, <br /> SITE ADDRESS: CITY/STATE/ZIP, � <br /> c <br /> CHANGES SITE/OWNER/PERMIT? YES O TANK Ot TANK C>, TANK 0 TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION ]SITE�rCO�MPUTER PER# PER# PER# PER# <br /> / &<,(, { Y1.�1 EXP.DATE EXP.[SATE EXP.DATE EXP,DATE <br /> TANK CONTENTS <br /> OPERATIONAL TANK <br /> MAJOW MINOR <br /> PERMIT TO OPERATE 1 2 <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 <br /> APPROVED CONSTRUCTION 5 6 <br /> WRITTEN MONITORING PROCEDURES -F-71 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 2$ <br /> SAMPLING 29 30 <br /> APPROVED TANK REPAIRS 31 32 --- -- <br /> UNAUTHORIZED RELEASES REPORTED 33 <br /> SAFETY HAZARD 135 136 <br /> CONDITIONS ABATED V37 <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 44 146 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 149 - <br /> FLAMMABLE VAPORS REMOVED 50 pm _ <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 /> 59 <br /> MAJOR 57 MINOR n NO ❑ <br /> VIOL. VIOL. LJ VIOL. -- - <br /> OFFICE: INSP: - <br /> TITLE: -RE,R PEON ' K:� � <br /> HUT-3 ORIGINAL <br />