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UNDERGRO TANK PROGRAM OFFICIAL INSP TION REPORT <br />WAN JOAQUIN HEALTH DISTRIC <br />1601 E. HAZELTON AVE. <br />COUNTY NAME STOCKTON, CA 95205 COUNTY # <br />PHONE NO. 468-3423 <br />SITE NAME: ` <br />46 <br />47 <br />INSPECTION DATE: 3. -23-7 3 <br />SITE ADDRESS: 3y j ai4 <br />49 <br />CITY/STATE/ZIP <br />61-1 <br />FLAMMABLE VAPORS REMOVED <br />50 <br />UNAUTHORIZED RELEASE <br />51 <br />52 <br />CHANGES SITE/OWNER/PERMIT? <br />YES <br />NO <br />TANK <br />j <br />TANK 2.,_ <br />TANK 7J <br />TANK <br />FORM A AND/OR B SUBMITTED? <br />56 <br />COMPUTER <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />FOLLOWS: <br />COMPUTER <br />COMPUTER <br />COMPUTER <br />>✓ 7Z - <br />NUMBER <br />59 <br />NUMBER <br />NUMBER <br />NUMBER <br />TYPE OF INSPECTION <br />SITE COMPUTER # <br />2;,1-s T <br />`I 77 <br />PER # <br />PER # <br />PER # <br />PER # <br />/7 <br />r <br />EXP. DATE <br />EXP. DATE <br />EXP. DATE <br />EXP. DATE <br />OPERAT ONAL TANK <br />TANK <br />CONTENTS <br />MAJOR MINOR <br />PERMIT TO OPERATE <br />1 <br />2 <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 />136 <br />CONDITIONS ABATED <br />37�� <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL <br />38 <br />39 <br />FLAMMABLE VAPORS REMOVED <br />40 <br />ACCESS LOCATIONS SEALED <br />41 <br />42 <br />POWER DISCONNECTED <br />43 <br />OWNER/OPERATOR MONITORING <br />44 <br />45 <br />PERMANENT TANK CLOSURE <br />REMOVAL OF RESIDUAL MATERIALS <br />46 <br />47 <br />PIPING <br />48 <br />49 <br />FLAMMABLE VAPORS REMOVED <br />50 <br />UNAUTHORIZED RELEASE <br />51 <br />52 <br />SAMPLING <br />53 <br />54 <br />IMPROPER ABANDONMENT <br />55 <br />56 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />FOLLOWS: <br />SYSTEM STATUS (MUST MARK ONE) <br />>✓ 7Z - <br />57 <br />59 <br />VIOL58 <br />MAJOR . VIOL.. MINOR ❑ <br />VIOL. <br />NO <br />VIOL. ❑ <br />OFFICE:INSP ��/ 13 C90VED <br />l' I TITLE: <br />i .� vn�uuvn� <br />