Laserfiche WebLink
Y` UNDERGROUN^ "+K PROGRAM OFFICIAL INSPEe N REPORT <br /> -% � JOAQUIN HEAoLTH DISTRICT1601 E. HAZELTN AVE. <br /> COUNTY NAME -�- STOCKTON, CA 95205 COUNTY # C <br /> I ✓0're c""" PHONE NO. 468-3423 �7 <br /> SITE NAME: r INSPECTION DATE: /6 a3 =f <br /> SITE ADDRESS: /J CITY/STATE/ZIP �1L Cy <br /> Q�J n r L <br /> CHANGES SITE/OWNER/PERMIT? YES N TANK TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER # NUMBER NUMBER NUMBER NUMBER <br /> _ PER # PER # PER # PER # <br /> EXP.DATE EXP.DATE EXP.DATE EXP DATE <br /> OPERA ZONAL 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 <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 mm <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED M44 <br /> OWNER/OPERATOR MONITORING <br /> PERMANENT TANK CLOSURE <br /> eREMOVAL OF RESIDUAL MATERIALS 46 47 48 49 <br /> ABLE 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 W <br /> SYSTEMA STATUS(MUST MARK ONE) <br /> FOLLOWS:57 68 <br /> tty <br /> MAJOR MINOR NO 59 <br /> VIOL. VIOL. VIOL. <br /> OFFICE: INSP: <br /> TITLE: PHONE. <br />._ RECK: _ -- - <br /> �" ,_, _ w__ ��_ _ _.... <br /> HUT---3 ORIGINAL <br />