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�'UNDERGRO[` TANK PROGRAM OFFICIAL INS ;""SON REPORT <br /> '%O��N JOAQUIN HEALTH DISTRICv.W�j <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME ST005205 <br /> PHONE NO- 468-3 23 COUNTY # <br /> SITE NAME: , <br /> i" INSPECTION DATE: <br /> ;SITE ADDRESS: CITY/STATE/ZIP <br /> 1 �i �,.ft <br /> CHANGES SITE/OWNER/PERMIT? ES NO TANK TANK TANK TANK <br /> ORM A AND/OR 8 SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBER NUMBER NUMBER <br /> PER t�JG o2y�6_ PER# PER s PER 0 <br /> EXP.DAITEE" e� EXP.DATE EXP:DATE EXP.DATE <br /> 1 OPERATIONAL LANK """ come <br /> MAJOR MINOR <br /> 1 PERMIT TO OPERATE 1 2 <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 <br /> i APPROVED CONSTRUCTION 5 g <br /> }WRITTEN MONITORING PROCEDURES 7 8 ----- - <br /> APPROVED MONITORING SYSTEM 9 10 -- <br /> �MONITORING SYSTEM 11 12 <br /> APPROVED MONITOR FREQUENCY 13 14 - - <br /> MONITORM RECORDS MAINTAINED 15 16 - <br /> ACCESS CASING SECURED 17 18 <br /> ]PIPING 19 20 <br /> 11NVENT•ORY RECONCIUATION 21 22 <br /> TANK GAUGING 23 24 — `-- <br /> )APPROVED RESPONSE PLAN 25 26 <br /> )UNAUTHORIZED RELEASE OCCURRENCE 27 28 <br /> ISAMPLING 29 30 --- <br /> fPPROVED TANK REPAIRS 31 32 <br /> NAUTHORIZED RELEASES REPORTED 33 34 -- <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 37 <br /> I <br /> TEMPORARY TANK CLOSURE <br /> IttEMOVAL OF RESIDUAL 38 39 <br /> rLAMMABLE VAPORS REMOVED 40 <br /> IACCESS LOCATIONS SEALED 41 42 <br /> r'OWER DISCONNECTED 43 <br /> ER/OPERATOR MONITORING 44 45 <br /> f <br /> PERMANENT TANK CLOSURE <br /> �EMOVAL OF RESIDUAL MATERIALS 46 47 <br /> IPING 48 49 <br /> FLAMMABLE VAPORS REMOVED 50 <br /> C bNAUTHORtZED RELEASE 51 52 - <br /> SAMPLING 53 54 --.-.. <br /> PROPER ABANDONMENT 155 156 _----- ��-- <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> �ISTEM STATUS(MUST MARK ONE} FOLLOWS: / <br /> MAJOR 57 MINOR 56 NO j`�� <br /> wTOL ❑ VIOL ❑ VIOL I—! <br /> t <br /> r <br /> sFFICE: INSP: RECEIVED BY: <br /> TITLE: pE�C,/S �• PHONE: RECK: <br /> 3 <br /> 411 IT-7 r......e-....a:a.i.... _.__ .. <br />