Laserfiche WebLink
UNDERGROUND,TANK PROGRAM OFFICIAL INSEr*CT�N REPORT f14K <br /> JOAQUIN HEALTH DISTRIC <br /> 1601 E. HAZELTON AVE. <br /> STOCKTON, CA 95205 COUNTY # <br /> COUNTY NAME PHONE NO. 468-3423 <br /> SITE NAME: i INSPECTION DATE: . <br /> SITE ADDRESS: d� /j � � �� CIT�YG�T/�T���1Py GJ� � <br /> CHANGES SITE/OWNER/ PERMIT? YES NO TANK TANK vu� NK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTEROMPUTEN R COMPUTER COMPUTER <br /> ON SITE COMPUTER # <br /> NUMBER/a �'a U'�},�t��'��,��ff NUMBER NUMBER <br /> TYPE OF INSPECTI / PER # PER # PER # PER # <br /> 6 EXP. DATE EXP. DATE EXP. DATE EXP. DATE <br /> OPERATIONAL TANK - mN-----T <br /> MAJOR CON�Nis <br /> 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 FREOUENCY 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ACCESS CASING SECURED 17 18 <br /> PIPING 19 120 <br /> INVENTORY RECONCILIATION 21 122 <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 6I <br /> 1 <br /> TEMPORARY TANK CLOSURE <br /> rl <br /> REMOVAL OF RESIDUAL W43 <br /> _ <br /> FLAMMABLE VAPORS REMOVED <br /> ACCESS LOCATIONS SEALED <br /> POWER DISCONNECTED OWNER/OPERATOR MONITORING <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 ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS IiI <br /> SYSTEM STATUS (MUST MARK ONE) FOLLOWS: 3 <br /> MAJOR 57 MINOR 59 NO 59 <br /> VIOL ❑ VIOL. ❑ VIOL I <br /> OFFICE: INSP: RECEIVED BY: <br /> TITLE f §at� PHONE: RECK: <br /> sine <br /> HUT-3 ORIGINAL © <br />