Laserfiche WebLink
UNDERGROUC"',TANK PROGRAM OFFICIAL INSP-' 'TION REPORT <br /> SAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> O. <br /> COUNTY NAME Sawn oa -r GI�L+.� STOCKTCA 95205 COUNTY # <br /> PHONE NNO. 468-3423 <br /> SITE NAME: (20 <br /> CGS. /V.. Q INSPECTION DATE: ^ ¢ <br /> SITE ADDRESS: 0 Q �. �� wojl CITY/STATE/ZIP 34,er cfil <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANKo TANK TANK TANK <br /> FORM A AND/OR B SUBMITTED? COMPU ER COMPUTER COMPUTER COMPUTER <br /> TYPE OF INSPECTION SITE COMPUTER# NUMBER I a Q7 NUMBER /X47 NUMBER NUMBER <br /> F I PER# PER# PER# PER# <br /> EXP.DATE EXP.DATE EXP.DATE EXP.DATE <br /> OPERATIONAL TANK TANK CONTENTS <br /> MAJOR MINOR <br /> PERMIT TO OPERATE 1 2 <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 <br /> APPROVED CONSTRUCTION 5 6 <br /> WRITTEN MONITORING PROCEDURES 7 8 <br /> APPROVED MONITORING SYSTEM g 10 <br /> MONITORING SYSTEM 11 12 <br /> APPROVED MONITOR FREQUENCY 13 14 <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 µ_ <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 34 <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED 40 ME <br /> ACCESS LOCATIONS SEALED 41 42 <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 <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) FOLLOWS: �J <br /> 57 / . l�I/1110 f- - - <br /> 147 <br /> VIOL.OR ❑ VIOL. <br /> MAJOR VOL.LJ _ <br /> OFFICE: INSP: RECEIVED BY: <br /> TITLE�/ <br /> d"� 'lam PHONE: BECK: <br /> NUT-3 ORIGINAL 5/88 O M <br />