Laserfiche WebLink
UNDERGROU NK PROGRAM OFFICIAL INSP N REPORT <br /> �N JOAQUIN HEALTH DISTRICT / <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY # 3`� <br /> PHONE NO. 468-3423 <br /> SITE NAME: � S l tA� INSPECTION DATE: /- ��p <br /> SITE ADDRESS: CITY/STATE/ZIP <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK Z TANK TANK <br /> FORM RAND/OR B SUBMITTED? COMPUTER Da COMPUTER�0�y..( COMPUTER COMPUTER <br /> NUMBER NUMBER ff//S_ NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER# 5 PER# UL' t PER# PER# <br /> YF Dq Ail/ 15-5 (f) EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <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 _ <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ACCESS CASING SECURED 17 118 <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 38 39 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 - -- <br /> OWNER/OPERATOR MONITORING 44 45 <br /> 7 <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS [t771 <br /> PIPING <br /> FLAMMABLE VAPORS REMOVED <br /> UNAUTHORIZED RELEASE <br /> SAMPLING -- - <br /> IMPROPER ABANDONMENT <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORREC D AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> MAJOR 57 MINOR 58 NO 59 <br /> VIOL ❑ VIOL 1:1VIOL.jY <br /> OFFICE: INSP: / /' RECEIVED BY: <br /> TITLE:(/p�y PHONE: BECK: <br /> HUT-3 ORIGINAL <br />