Laserfiche WebLink
UNDERGROUNF ANK PROGRAM OFFICIAL INSPEr ­ON REPORT <br /> 4N JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY # ' <br /> PHONE NO. 468-3423 <br /> SITE NAME: � T12— IST`_0 INSPECTION DATE: <br /> SITE ADDRESS: A,,% CITY/STATE/ZIP 5�rG� <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK 6 TANK '7 TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTE <br /> TYPE OF INSPECTION SITE COMPUTER# PER BEFYoJ��(J PER BER !�r(� NUMBEF�o Ci C9 (� NUMB <br /> PER p <br /> /� l �/ -✓� EXP.DATE O/'e S EXP.DATE �1144 EXP.DATE UA) EXP.DATE Ll <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 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 -w <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 y <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 50 <br /> UNAUTHORIZED RELEASE 51 52 <br /> SAMPLING 53 54 <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED TEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: 4i r0d r <br /> ./ s nJ _ 3 <br /> MAJOR 57 MINOR 58 NO '% " iS — <br /> VIOL. ❑ vloL. ❑ v1oL, /ZF C ^/ ✓pec✓ o <br /> - -- - - ¢. <br /> OFFICE INSP: G�� �w, RECEIVE Y: <br /> zz/ TITLE: ECK: <br /> 7V �3 <br /> NUT-3 ORIGINAL 5/88 0M <br />