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UNDERGROATANK PROGRAM OFFICIAL SAN J4AQUlN HEALTH DISTRICT ��TION REPORT 1601 E. HAZELTON AVE. STOCKTON, CA 95205 COUNTY # '� COUNTY MME PHONE NO. 468-3423 f INSPECTION DATE: ,' /Iq z— SITE NAME: %��j�.r• ,,>� : , -_ ;��,� ,.fes .. J SITE ADDRESS: . CITY/STATE/ZIP P!t�r.J CHANGES SITE/OWNER/PERMIT? YES NO TANK _ TANK TANK TANK FARM RAND/OR B SUBMITTED? _ COMPUTER COMPUTER COMPUTER COMPUTER ' NUMBER l +a NUMBER NUMBER NUMBER TYPE OF INSPECTION AV;4 R# PER # PER # PER # PER j EXP DATE EXP.DATE EXP,DATE EXP.DATE TANK CONTENTS it OPERATIONAL TANK MAJOR MINOR j PERMIT TO OPERATE 1 2 EI CHANGE IN CONDITIONS TO OPERATE 3 4 -- APPROVED CONSTRUCTION 5 6 ---- i WRITTEN MONITORING PROCEDURES 7 8 APPROVED MONITORING SYSTEM 9 10 - - MONITORING SYSTEM 11 12 - - APPROVED MONITOR FREQUENCY 13 14 MONITORING RECORDS MAINTAINED 15 16 - i ACCESS CASING SECURED 17 18 -- - PIPING 19 20 INVENTORY RECONCILIATION 21 22 - ---- TANK GAUGING 23 24 - APPROVED RESPONSE PLAN 25 26 UNAUTHORIZED RELEASE OCCURRENCE 27 28 SAMPLING 29 30 APPROVED TANK REPAIRS 31 32 _ -- UNAUTHORIZED RELEASES REPORTED 33 34 ---,_ -------- - _ SAFETY HAZARD 35 36 CONDITIONS ABATED 37 TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL38 39 FLAMMABLE VAPORS REMOVED 40 ---- ----- ACCESS LOCATIONS SEALED 41 42 — i POWER DISCONNECTED m 43 OWNER/OPERATOR MONITORING 44 45 PERMANENT TANK CLOSURE REMOVAL OF RESIDUAL MATERIALS 46jj��j PIPING 48 FLAMMABLE VAPORS REMOVED 50 UNAUTHORIZED RELEASE 51 52 -- SAMPLING 53 54 IMPROPER ABANDONMENT 56 1`r THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: �-r2�: MAJOR 57 MINOR NO 58 59 VIOL. I d VIOL. ❑ VIOL.LJ OFFICE: INSP. -- RECEIVED BY: TITLE: � I ,1�'� . PHONE:: BECK: � Ht IT-3 FILE COPY eras