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c UNDERGROU'1,�NK PROGRAM OFFICIAL INSF IN REPORT p 1 of 5 'W N JOAQUIN HEALTH DISTRICTLr� ._ 1601 E. HAZELTON AVE! COUNTY NAME STOCKTON, CA 95205 q PHONE NO. 468-3423/ COUNTY #- 3/ SITE NAME: _ C �I55 oro la L • CP c�I Lie GMC,!1SEECTION DATE: -7—�,/ 9/ SITE ADDRESS: �T £ /R / , I T TE/ZIP G�s2-7/6 CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK /TANK FORM A AND/OR B SUBMITTED? COMPUTER, COMPUTE] COMPUTE Qpm COMPUTER TYPE OF INSPECTION SITE COMPUTER# NUMBER NUMBEis t, NUMBER ' j . NUMBER ` - / PER# �I r PER# - PER# /GJ/(].�� PER# - 0 / / EXP.DA�B�D �` EXP.D �'S EXP.DATE-- 0 EXP.DATE OPERATIONAL TANK TMK COWENTS " ✓' MAJOR FIMINOR t f 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 I 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 34 SAFETYHAZARD 135 36 1 - CONDITIONS ABATED 37 _ # TEMPORARY TANK CLOSURE Mgt k t REMOVAL OF RESIDUAL W43 _ '! FLAMMABLE VAPORS REMOVED - ACCESS LOCATIONS SEALED - POWER DISCONNECTED OWNER/OPERATOR MONITORING I PERMANENT TANK CLOSURE A REMOVAL OF RESIDUAL MATERIALS 46 47 PIPING : 48 49 FLAMMABLE VAPORS REMOVED - 50 UNAUTHORIZED RELEASE 51 - 52 SAMPLING - 53 54 _ IMPROPER ABANDONMENT 55 56 THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS SYSTEM STATUS(MUST MARK ONE) FOLLOWS: 93 � MAJOR! 57 MINOR 58 NO K VIOL. ❑ VIOL ❑ VIOL. /J rSa, i OFFICE: INSP:G,/ RECEIVED BY: I _ TITLE: PHONE: BECK: HUT-3 - ORIGINAL siea OM