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x; <br />UNDERGROUNNK PROGRAM OFFICIAL INSPEON REPORT <br />AN JOAQUIN HEALTH DISTRICT it <br />.+ 1601 E. HAZELTON AVE. <br />COUNTY NAME�a� STOCKTON, CA 95205 COUNTY # <br />OQ tJ PHONE NO. 468-3423 q <br />SITE NAME:- INSPECTION DATE: <br />REMOVAL OF RESIDUAL MATERIALS 46 47 <br />PIPING 48 49 w]� <br />FLAMMABLE VAPORS REMOVED 50 <br />UNAUTHORIZED RELEASE 51 52 <br />SAMPLING 53 54 <br />IMPROPER ABANDONMENT 155 156 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />SYSTEM STATUS (MU§T MARK ONE) ryo V /o lef4loa5 FOLLOWS: e a�Ir✓url) S9 0150 <br />c>cCu recl dtkrr <br />57 58 59 <br />MAJOR NO <br />VIOL. ❑ VIOLL..R ❑ VOL. <br />I I OFFICE: <br />HUT -3 <br />INSP: RECEIVED BY: <br />C IUfiles 44c4ll+ <br />TITLE: jF,q S PHONE: 77BECK: <br />ORIGINAL <br />5/88 © a <br />,--s% 2 <br />AWI yv <br />SITE ADDRESS: <br />CITY/STATE/ZIP <br />C - <br />CHANGES SITE/OWNER/PERMIT? <br />YES <br />NO <br />TANK <br />TANK <br />TANK <br />TANK <br />FORM A AND/OR B SUBMITTED? <br />h� <br />COMPUTER <br />COMPUTER <br />COMPUTER <br />COMPUTER <br />NUMBER <br />NUMBER <br />NUMBER <br />NUMBER <br />TYPE OF INSPECTION SITE COMPUTER # <br />PER # <br />PER # <br />PER # <br />PER # <br />'►^� I7, ��D <br />EXP. DATE <br />EXP. DATE <br />EXP. DATE <br />EXP. DATE <br />OPERATIONAt TANK <br />TANK CONTENTS <br />Em <br />MAJOR MINOR <br />PERMIT TO OPERATE <br />1 <br />2 <br />" <br />CHANGE IN CONDITIONS TO OPERATE <br />3 <br />4 <br />APPROVED CONSTRUCTION <br />5 <br />6 <br />WRITTEN MONITORING PROCEDURES <br />7 <br />8 <br />APPROVED MONITORING SYSTEM <br />9 <br />10 <br />MONITORING SYSTEM <br />11 <br />12 <br />APPROVED MONITOR FREQUENCY <br />13 <br />14 <br />MONITORING RECORDS MAINTAINED <br />15 <br />16 <br />ACCESS CASING SECURED <br />17 <br />18 <br />PIPING <br />19 <br />20 <br />INVENTORY RECONCILIATION <br />21 <br />22 <br />TANK GAUGING <br />23 <br />24 <br />APPROVED RESPONSE PLAN <br />25 <br />26 <br />UNAUTHORIZED RELEASE OCCURRENCE <br />27 <br />28 <br />SAMPLING <br />29 <br />30 <br />APPROVED TANK REPAIRS <br />31 <br />32 <br />UNAUTHORIZED RELEASES REPORTED <br />33 <br />34 <br />SAFETY HAZARD <br />35 <br />36 <br />wY"_ <br />CONDITIONS ABATED <br />37 <br />TEMPORARY TANK CLOSUREmilli <br />Iiiii'll <br />REMOVAL OF RESIDUAL <br />38 <br />39 <br />FLAMMABLE VAPORS REMOVED <br />40 <br />ACCESS LOCATIONS SEALED <br />41 <br />42 <br />ry <br />POWER DISCONNECTED <br />43 <br />ry <br />ry <br />OWNER/OPERATOR MONITORING <br />44 <br />45 <br />PERMANENT TANK CLOSURE <br />minim= <br />REMOVAL OF RESIDUAL MATERIALS 46 47 <br />PIPING 48 49 w]� <br />FLAMMABLE VAPORS REMOVED 50 <br />UNAUTHORIZED RELEASE 51 52 <br />SAMPLING 53 54 <br />IMPROPER ABANDONMENT 155 156 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />SYSTEM STATUS (MU§T MARK ONE) ryo V /o lef4loa5 FOLLOWS: e a�Ir✓url) S9 0150 <br />c>cCu recl dtkrr <br />57 58 59 <br />MAJOR NO <br />VIOL. ❑ VIOLL..R ❑ VOL. <br />I I OFFICE: <br />HUT -3 <br />INSP: RECEIVED BY: <br />C IUfiles 44c4ll+ <br />TITLE: jF,q S PHONE: 77BECK: <br />ORIGINAL <br />5/88 © a <br />