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UNDERGROUANK PROGRAM OFFICIAL INSP ION REPORT <br /> AN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME J STOCKTON, CA 95205 COUNTY # <br /> U OQ C{(N PHONE NO. 468-3423 *33 <br /> SITE NAME: old e q INSPECTION DATE: 3hjq� <br /> SITE ADDRESS: 601 "5 I CITY/STATE/ZIP s4rooN g52,O3 <br /> CHANGES SITE/OWNER/PERMIT? YE NO TANK TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# <br /> Re40jva� ^ PER # PER# PER# PER# <br /> //�,amu�k EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR I 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 17 118 <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 28 <br /> SAMPLING 29 30 <br /> APPROVED TANK REPAIRS 31 32 - <br /> UNAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 37VIA <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL W4142 <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED POWER DISCONNECTED OWNER/OPERATOR MONITORING T <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 VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: 0bS< C0( f m o 000 r e Q'A' <br /> 57 58 59Nu <br /> MINOR NO kar ed Okb, slOJOR INVIOL.El rscoi rov a <br /> L. <br /> OFFICE: INSPC U/Lt RECEIVED BY: <br /> TITLE: lsof r' C fd1.> PHONE: BECK: <br /> HUT-3 ORIGINAL 5/BS O <br />