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UNDERGROUKD TANAI OGRAM OFFICIAL INSPECON REPORT <br />SAN J AQUIN LOCAL HEALTH DISTRICT <br />SITE NAME (1Gi s r ! �� r� INSP DATE: <br />SITE ADDRESS 1q.0 -r/? � C/S/z E -,s c- o k,19, CA X532© <br />CHANGES SITE/OWNER/OPER 7 TANK --f ( TANK TANK -W3 TANK <br />YES NO M.F.R. SUBMIT. ID N I-E'q • 10 M 012. Sed ID 0 (SIL 1D M <br />SITE COMP.E OF NSP PER N 100 CCOG4L PER M 61COOf�L 6PER 15iOoC) C,{t PER M <br />G u 1, n �_ Exp If" DATE ExP DATE I" DATE <br />OPEPATIOeuw vrOLATIONS IZ111111111 71711171114i1111L1111 <br />1. Permit to Operate <br />2. Change in Cond. to Operate <br />3. Approved Construction 0 _ <br />4. Written Monitoring Procedures M,' 4v- 5- S M ' <br />t�. Approved Monitoring System C -)k, <br />6. Monitoring System Operational <br />7 Approved Monitoring Frequency '/ ✓ ' <br />8. Monitoring Records Maintained g' <br />Access Casing Secured o <br />10. Piping UK OK I <br />11 Inventory Reconciliation v� <br />12. Tank Guaginq <br />13. Approved Renponae Plan <br />14. Unauthorized Release Occurrence <br />16. Approved Tank Repairs <br />17. Unauthorized Releases Reportbd <br />18 Safety Hazard <br />19. Conditions Abated <br />TLIWC JM QaSUIRE <br />20. Removal of Residual Materials <br />21. Flarmwble Vapors Removed <br />22. Access Locations Sealed <br />23. Power Disconnected <br />24. Owner/Operator Monitoring <br />Pt2*V 2fr CLOSURE <br />25. Renwval of Residual Materials Tj <br />26. Piping - <br />27. Flammable Vapors Removed <br />28. Unauthorized Release <br />29 Sampling <br />30. Improper Abandonment <br />marked Items represent viola lon■ and dust be corrected a■ fo laws: <br />ri o �L bP1 m > ' <br />a Sr !' least 3 a_ <br />A rr <br />'rJ Q 1 r r <br />f ' �' ►0 Y1 Gt �� <br />ti to f?O <br />, _L- -Scr <br />SANIOA'6I]IN LOCAL HEATH DISTRI .P' i <br />POST OFFICC BOX 2009 O�YI'M� G� pd� Y1e <br />r � � <br />STOCKTON. CALIF. 95201 PHONE TI RECHECK: <br />ATTN: ENVIRON. HEALTH (,-2-0 .2-3 Cl-g1.,�-Ll <br />70 <br />