Laserfiche WebLink
UNDERGROU' TANK PROGRAM OFFICIAL INSP' 'TION 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: whINSPECTION DATE: it -t _S/6(4 &� V_� <br />SITE ADDRESS: A 1 CITY/STATE/ZIP C�N V fj- <br />CHANGES SITE/OWNER/PERMIT? YES NO <br />FORM A AND/OR B SUBMITTED? <br />TANK TANK <br />COMPUTER COMPUTER <br />NUMBER NUMBER <br />PER # PER # <br />EXP. DATE EXP. DATE <br />TANK <br />COMPUTER <br />NUMBER <br />PER # <br />EXP. DATE <br />TANK <br />COMPUTER <br />NUMBER <br />PER # <br />EXP. DATE <br />TYPE OF I ECTIONSITE <br />COMPUTER # <br />OPERATIONAL TANK <br />PERMIT TO OPERATE <br />CHANGE IN CONDITIONS TO OPERATE <br />APPROVED CONSTRUCTION <br />WRITTEN MONITORING PROCEDURES <br />APPROVED MONITORING SYSTEM <br />MONITORING SYSTEM <br />APPROVED MONITOR FREQUENCY <br />MONITORING RECORDS MAINTAINED <br />ACCESS CASING SECURED <br />PIPING <br />INVENTORY RECONCILIATION <br />TANK GAUGING <br />APPROVED RESPONSE PLAN <br />UNAUTHORIZED RELEASE OCCURRENCE <br />SAMPLING <br />APPROVED TANK REPAIRS <br />UNAUTHORIZED RELEASES REPORTED <br />SAFETY HAZARD <br />TANK CONTENTS <br />38 <br />139 <br />MAJOR MINOR <br />1 2 <br />f <br />ACCESS LOCATIONS SEALED <br />3 4 <br />5 6 <br />7 8 <br />ME <br />9 10 <br />11 12 <br />44 <br />13 14 <br />15 16 <br />17 18 <br />REMOVAL OF RESIDUAL MATERIALS <br />46 <br />19 20 <br />PIPING <br />21 22 <br />_ <br />23 24 <br />50 <br />25 126 1 <br />UNAUTHORIZED RELEASE <br />51 <br />27 28 <br />_ <br />SAMPLING <br />53 <br />29 30 <br />31 32 <br />33 34 <br />35 36 <br />CONDITIONS ABATED <br />37 <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL <br />38 <br />139 <br />FLAMMABLE VAPORS REMOVED <br />40 <br />ACCESS LOCATIONS SEALED <br />41 <br />42 <br />POWER DISCONNECTED <br />ME <br />43 <br />OWNER/OPERATOR MONITORING <br />44 <br />45 <br />PERMANENT TANK CLOSURE <br />REMOVAL OF RESIDUAL MATERIALS <br />46 <br />147 <br />PIPING <br />48 <br />49 <br />FLAMMABLE VAPORS REMOVED <br />50 <br />UNAUTHORIZED RELEASE <br />51 <br />52 <br />SAMPLING <br />53 <br />54 <br />IMPROPER ABANDONMENT 55 56 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />SYSTEM STATUS (MUST MARK ONE) FOLLOWS: / "o <br />MAJOR J MINOR 58 NO 59 <br />VIOL. ❑ VIOL ❑ VIOL. <br />OFFICE: INSP: �y RECEIVED BY: <br />TITLE/�N�'f PHONE: <br />HUT -3 ORIGINAL <br />BECK: <br />5/88 Om <br />