Laserfiche WebLink
UNDERGROUND---'INK PROGRAM OFFICIAL INSPEC"N REPORT <br /> ;> 4 JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> CA 5205 <br /> COUNTY NAME PHONETNO. 46893423 COUNTY # <br /> SITE NAME: S �(�� /w� INSPECTION DATE: <br /> SITE ADDRESS: - /Y�� o� � CITY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK Z TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE INSPECTION SITE COMPUTE/RR# PER# PER# PER# PER# <br /> �` , p1 If 164 EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK co R34 <br /> N 0 <br /> PERMIT TO OPERATE <br /> CHANGE IN CONDITIONS TO OPERATE APPROVED CONSTRUCTION WRITTEN MONITORING PROCEDURES APPROVED MONITORING SYSTEM MONITORING SYSTEM APPROVED MONITOR FREQUENCY MONITORING RECORDS MAINTAINED <br /> ACCESS CASING SECURED 17 18 <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 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 130 139 <br /> FLAMMABLE VAPORS REMOVED W1427 <br /> ACCESS LOCATIONS SEALED POWER DISCONNECTED OWNER/OPERATOR MONITORING <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 /> SAMPUNG 53 54 <br /> IMPROPER ABANDONMENT 55 56 LL <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS IMUST MARK ONE) FOLLOWS: <br /> 2✓C <br /> MAJOR 57 MINOR 58 NO 5 <br /> VIOL. ❑ VIOL. ❑ VIOL. <br /> OFFICE: INSP. CEIVED BY: <br /> TITLE: f`15�C PHONE: R CK: <br /> HUT-3 ORIGINAL 5/88 O <br />