Laserfiche WebLink
AGROUND TANK OFFICIAL INSPECTION RORT <br /> SAN JOAQUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 445 N.San Joaquin Street <br /> Mailing Address: P.O.Boz 388 <br /> COUNTY NAME SCryU <br /> Stockton,4CA <br /> 88 3420 1-0388 COUNTY #2 j <br /> SITE NAME: Yaz;�u INSPECTION DATE: <br /> SITE ADDRESS: //OA Sr S - CITY/STATE/ZIP �'f ��iy1l CR Z Jrad <br /> CHANGES SITE YES NO TANK I TANK I, TANK_ � TANK '? <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSP TION SITES COMPUTER# PER# PER# PER# PER# <br /> / I <br /> r0 Oti EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIOfNAL TANK TANK CONTENTS p 000 02 600 D bb <br /> MAJOR 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 �"� 1-�G,{ re YA&wd V140- <br /> MONITORING RECORDS MAINTAINED 15 a . <br /> ACCESS CASING SECURED 17 18 <br /> ____ <br /> PIPING 19 20 be <br /> INVENTORY RECONCILIATION 21 22 <br /> TANK GAUGING 23 24 <br /> --------------- <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 /> _.. ._ ._...__..__. _...__---.._.-----.._.-.. <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL38 39 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 <br /> OWNER/OPERATOR MONITORING 44 45 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 <br /> PIPING 48 49 <br /> FLAMMABLE VAPORS REMOVED 50mm <br /> / <br /> UNAUTHORIZED RELEASE 51 52 V <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: <br /> 57 58 59 <br /> MAJOVIOL. <br /> ❑ vIOL. El VIOLNO . <br /> OFFICE: INSP' r RECEIVED BY: <br /> TITL • SeNI D PHONE: BECK: <br /> srae OM <br />