FIELD DOCUMENTS - Laserfiche WebLink

Home Browse Search

� rr "qON REPORT UNDERGROUITANK PROGRAM OFFICIAL INSPI i 1-- :-AN JOAQUIN HEALTH DISTRICT 1601 E. HAZELTON AVE. COUNTY # ! STOCKTON, CA 95205 COUNTY NAME PHONE NO. 468-3423 / INSPECTION DATE:3/3T SITE NAME: I)G 4-( , SITE ADDRESS: �3 Z /V A�/ //�!{(/Q CITY/ 0/ �� 6� - 9 5 CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TA K TANK FCOMPUTER COMPUTER COMPUTER COMPUTER ORM AAND/OR B SUBMITTED? NUMBER NUMBER NUMBER NUMBER TYPE OF INSPECTION SITE COMPUTER # PER# PER # PER # PER# TE EXP.DATE' EXP.DATE EXP.BATE EXP.DA 21 . . TANK CONTENTS ' OPERATIONAL TANK MAJOR MINOR PERMIT TO OPERATE 1 2 -- — CHANGE IN CONDITIONS TO OPERATE 3 4 — _ — APPROVED CONSTRUCTION 5 6 --_ — —--- —� WRITTEN MONITORING PROCEDURES 7 8 APPROVED MONITORING SYSTEM 9 10 — MONITORING SYSTEM 11 12 - APPROVED MONITOR FREQUENCY 13 14 --- MONITORING RECORDS MAINTAINED 15 16 — --- ACCESS CASING SECURED 17 18 _ - --- — - --- 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 33 134 --- SAFETY HAZARD 35 36 CONDITIONS ABATED 37 TEMPORARY TANK CLOSURE REMOVAL OF RESIDUAL 38 39 - - FLAMMABLE VAPORS REMOVED 40 ACCESS LOCATIONS SEALED 41 42 POWER DISCONNECTED 43 OWNER/OPERATOR MONITORING 44 45 PERMANENT TANK CLOSURE ------------ REMOVAL OF RESIDUAL MATERIALS 46 47 _—�-- — _ —•- __ _ _ __.. — __. PIPING 48 49 FLAMMABLE VAPORS REMOVED 50 FUM -- _ -- _ — — UNAUTHORIZED RELEASE 51 52 SAMPLING 53 54 ------- IMPROPER __. _ __ --.__ _ _ ----IMPROPER ABANDONMENT 55 56 I THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE COR ECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: MAJOR 57 MINOR 58 NO 59 d VIOL. El VIOL. ❑ VIOL. OFFICE: 1NSP: ECENED BY: 1 TITLE: PHONE: BECK: I Saw U+ ORIGINAL