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UNDERGROU `TANK PROGRAM OFFICIAL INSP,pam'sTION REPORT <br /> _bAN JOAQUIN HEALT A DISTRICT, <br /> 1601 E. HAZELTON NVE. <br /> COUNTY NAMEi d�...d, STOCKTON, CA 95 05 COUNTY # • <br /> _541PHONE NO. 468-3 23 ! <br /> SITE,NAME: ' "� .- G�-� INSPECTION DATE: r/ JJ <br /> SITE ADDRESS: / CITY/STATE/ZIP jaL� <br /> CHANGES SITE/OWNER/PERMIT? YES NOi;TANK Irl TANK D TANK TANK <br /> FORM A AND/OR B SUBMITTED? Cl LA iCOMPUTER COMPUTER COMPUTER COMPUTER <br /> !NUMBER NUMBER NUMBER , 'NUMBER <br /> TYPE OF INSPECTION TSITE COMPUTER#.� -PER # PER# PER# l_ PER# <br /> 3 EXP.DATE EXP.DATE EXP.,D EXP.DATE <br /> ,...F. : eJ, , <br /> TANK CONTENTS �`' aar y 1« '`; s`S �� ``'�'"s` <br /> OPERATIONAL TANK �• <br /> MAJOR MINOR : ._.. ... �. a ;. ,. . �..2 e a .... <br /> PERMIT TO OPERATE rl 2 � __ <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 _ <br /> APPROVED CONSTRUCTIONi5 a <br /> 6 <br /> WRITTEN(MONITORING'PROCEDURES -7 8 _ w <br /> APPROVED MONITORING SYSTEM <br /> MONITORING SYSTEM 11 12 <br /> APPROVED tM- ONITOR FREQUENCY 4 1314 <br /> MONITORINc�RECORDS MAINTAINED 15' 1.6 <br /> ACCESS CASING SECURED 17 18 <br /> PIPING <br /> i- <br /> rINVENTORY RECONCILIATION 21 22 _ <br /> 'TANK GAUGING t 23 24 moi .:e-,: ' ``° <br /> APPROVED RESPONSE PLAN 25 '26 <br /> UNAUTHORIZED.RELEASE OCCURRENCE 27 <br /> SAMPLING 29 30 <br /> APPROVED TANK REPAIRS 31 32 _ � � <br /> UNAUTHORIZED RELEASES REPORTED 33 34 <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 370110m.%ggg, <br /> 77 <br /> eg <br /> TEMPORARY TANK CLOSURE d � k b° � � <br /> ash <br /> REMOVAL OF RESIDUAL 38 <br /> FLAMMABLE VAPORS'REMOVED, 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 <br /> OWNER/OPERATOR MONITORING 44 <br /> PERMANENT TANK CLOSURE "oo <br /> �` ° v� • <br /> REMOVAL OF RESIDUAL MATERIALS 46 47 � <br /> PIPING 48 49 _ -- <br /> FLAMMABLE VAPORS REMOVED 50 <br /> UNAUTHORIZED RELEASE 51 <br /> SAMPLING 53 <br />� IMPROPER ABANDONMENT 55� 567 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED A <br /> S)tSTEMSTATUS(MUST MARK ONE) <br /> FOLLOWS'-2y- <br /> 57,,,- <br /> OLLOWS: <br /> VIOL,MAJO <br /> qo <br /> VIOL . L-1 VOL. ` <br /> d <br /> OFFICE: INSP_ RECEIVED BY: <br /> 14, <br /> TITLE: ; PH NE: BECK: <br /> i„ HUT-3 .. <br /> FILE COPY 5188 OM <br />