Laserfiche WebLink
�- UNDERGROW TANK PROGRAM OFFICIAL IN �'V~TION REPORT <br /> ' <br /> SAN JOAQUIN HEALTH DISTR,.,,,� <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME PHONETONNO. 468934203 COUNTY # <br /> SITE NAME: INSPECTION DATE: <br /> SITE ADDRESS: cSPrG M, �'t� � CITY/STATE/ZIP '5K ( A R5Z) c7 <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK>,(p TANKIbjpp-fl2 TANK 1laivp-o3 TANK }La(,p-D <br /> FORM A AND/OR B SUBMITTED? COMPUTER COMPUTER COMPUTER COMPUTER <br /> NUMBER NUMBER NUMBER NUMBER <br /> TYPE OF INSPECTION SITE COMPUTER# PER# PER# PER# PER# <br /> EXP.DATE" EXP.DATE EXP.DATE EXP.DATE <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 <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 38 139 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 <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 /> ..._._...._.-._.- <br /> SAMPLING 53 54 <br /> IMPROPER ABANDONMENT 55 56 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK pNE) FOLLOWS: ~ <br /> 57 58 5 <br /> MAJOR MINOR NO <br /> VIOL. LiVIOL. ❑ VIOL. <br /> OFFICE: INSP: I RECEIVED BY: <br /> AseY`�oc.�� <br /> TITLE: t��i / PHONE: RECK: <br /> HUT-:q ORIC;INAL /'����IJJJ sae OM <br />