REMOVAL REMOVAL 1986 - Laserfiche WebLink

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UNDERGRO TANK PROGRAM OFFICIAL INSWON REPORT "RAN JOAQUIN HEALTH DISTRIC 1601 E. HAZELTON AVE. STOCKTON, CA 95205 COUNTY #� CIDUNTY NAME yy 4, PHONE NO. 468-3423 G �z SITE NAME: INSPECTION DATE: ! 0 J SITE ADDRESS: �dS D1 ��/, ^� CITY/STATE/ZIP ] CFIANGESSITE/OWNER/PERMIT? YES TANK o) TANK �Z TANK TANK FORM AAND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER NUMBER NUMBER NUMBER NUMBER TYPE OF INSPECTION SITE COMER# PER # PER# PER# PER# EXP.DATE EXP.DATE EXP.DATE EXP.DATE TANK CONTENTS OPERATIONAL TANK MAJOR MINOR PERMIT TO OPERATE 1 2 _ CHANGE IN CONDITIONS TO OPERATE 3 4 _ - --- APPROVED CONSTRUCTION 5 6 _ --- - -- WRITTEN MONITORING PROCEDURES 7 8 APPROVED MONITORING SYSTEM 9 10 -""- MONITORING SYSTEM 11 12 APPROVED MONITOR FREQUENCY 13 14C- MONITORING RECORDS MAINTAINED 15 16 -- 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 - - APPROVED TANK REPAIRS 31 32 - UNAUTHORIZED RELEASES REPORTED 33 34 - -- - SAFETY HAZARD 35 36 CONDITIONS ABATED - 37 TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 38 39 FLAMMABLE VAPORS REMOVED 40 _. .._..._ .___... ACCESS LOCATIONS SEALED 41 42 ._._. _-_..-. POWER DISCONNECTED 43 _.. OWNER/OPERATOR MONITORING 44 f] PERMANENT TANK CLOSURE REMOVAL OF RESIDUAL MATERIALS 46 47 PIPING 48 49 FLAMMABLE VAPORS REMOVED so -"----_--- UNAUTHORIZED RELEASE 51 52 i — — ---- —' SAMPLING 53 54 IMPROPER ABANDONMENT 55 56 THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: 7 58 59 MAJOR 5r(/ MINOR NO VIOL. L{LI VIOL. ❑ VIOL.❑ OFFICE: INSP: RECEIVED BY: l / m ad TITLE: PHO �.�J S NE: BECK: 5/88 ©M HUT-3 ORIGINAL