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UNDERGRC -" K PROGRAM OFFICIAL INcN REPORT i' JOAQUIN HEALTH DISTRIC 1601 E. HAZELTON - AVE. . :CbUIITY NAME _ _ STOCKTON, CA 95205 - , COUNTY # PHONE NO. 468-3423 SITE NAME: '� AoR P<o TP�v GIE L N 6 . INSPECTION DATE: SITE ADDRESS: , S O CITY/STATE/ZIP �7b,-(�7u _ �jS2®( !' CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK TANK FORM A AND/OR B SUBMITTED? COMPUTER - COMPUTER - - COMPUTER - COMPUTER - TYPE OF INSPECTION SITE COMPUTER # - NUMBEVq �" �� NUMBER NUMBER NMBER 6 PER # � n�da� UPER # PER # PER # r P� EXP. DATE " EXP. DATE EXP. DATE EXP. DATE OPEP, TIONAL TANK TANK CONTENTS - - _ MAJOR MINOR _ •h. PERMIT TO OPERATE - - 1�K 2 1 - ' CHANGE IN CONDITIONS TO OPERATE 3 4 APPROVED CONSTRUCTION 5 6 WRITTENMONITORINGPROCEDURES 7 8 - APPROVED MONITORING SYSTEM 9 10 MONITORING SYSTEM 11 12 - . APPROVED MONITOR FREQUENCY _ 1 14 - MONITORING RECORDS MAINTAINED 15 16 - ACCESS CASING_ SECURED- 17 118 PIPING 19 20 INVENTORY RECONCILIATION 21 22 TANK GAUGING 23 24 - - APPROVED RESPONSE PLAN 25 26 - UNAUTHORIZED RELEASE OCCURRENCE 27 28 - SAMPLING 29 30 _ - APPROVED TANK REPAIRS 31 32 UNAUTHORIZED RELEASES REPORTED 33 34 _ SAFETY HAZARD - 35 36 - CONDITIONS ABATED r37 - - - TEMPORARY TANK CLOSURE - REMOVAL OF RESIDUAL FLAMMABLE VAPORS REMOVED ACCESS LOCATIONS SEALED - - POWER DISCONNECTED - .OWNER/OPERATOR MONITORING 44 45 PERMANENT TANK CLOSURE REMOVAL OF RESIDUAL MATERIALS 46 47 PIPING 48 49 _ FLAMMABLE VAPORS REMOVED 50 UNAUTHORIZED RELEASE 51 52 - - - �SAMPLING 53 54 IMPROPER ABANDONMENT :55:X -E6 - THE MARKED ITEMS�REPRESENT VIOLATIONS AND MUST BE CORRECTED. AS SYSTEM STATUS (MUST MARK ONE) FOLLOWS: ` cc4yie MAJOR. 57 -MINOR 58 NO 59 VIOL. VIOL ❑ VIOL Q OFFICE: INSP RECEIVED BY: LIZ TITLE: 15�1j PHONE: RECK: s HUT-3 ORIGINAL