Laserfiche WebLink
UNDERGROUR0 TANK PROGRAM OFFICIAL INSPFrTION REPORT <br /> SAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> STOCKTON, CA 95205 <br /> COUNTY NAME COUNTY # <br /> ,,,�pm__ � PHONE NO. 468-3423 „� <br /> E <br /> SITE NAME: <br /> G yS INSPECTION DATE: S�S <br /> SITE ADDRESS_ [.eJ. , — CITY/STATE/ZIP 3 � <br /> CHANGES SITE/OWNER/PERMIT? YES O NK 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# I <br /> ���. EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIO AL TA TANK CONTENTS s� r 5}4 re y . a �� ry gra�v Ste' <br /> kr �s'r`' 1 $ '' �+ ^'ice A ��.` F 1 Lr �,� m°�i <br /> MAJOR MINOR �r „'� � '. � .':. is ...� * � � � a� Nr <br /> PERMIT TO OPERATE 1 2 <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 � I� - <br /> APPROVED CONSTRUCTION 5 6 <br /> WRITTEN MONITORING PROCEDURES 7 8 `t <br /> APPROVED MONITORING SYSTEM 9 10 <br /> MONITORING SYSTEM 11 12 ti <br /> APPROVED MONITOR FREQUENCY 13 14s <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 34i <br /> SAFETY HAZARD 35 136 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE v ¢d <br /> > s a , <br /> mwo <br /> 3 a <br /> REMOVAL OF RESIDUAL 38 39 I! <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 I <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 1-7 <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 <br /> SYSTEM STATUS(MUST MARK ONE) U; /d�jC p«r r�J <br /> C/ f^("aG NPji FOLLOWS: Pt tJec.� 1{f F i <br /> MAJOR 57 MINOR NO 59 <br /> VIOL. ❑ VIOL. ❑ VIOL.❑ �:;qe _1!; . � U j 45 . Aur <br /> OFFICE: INSP: d RECEIVED BY: <br /> TITLE: �,�f�r� PHONE: BECK: <br /> HUT-3 ti. OWNER'S COPY s as OM <br />