Laserfiche WebLink
UNDERGROUN ANK PROGRAM OFFICIAL INSPE ON REPORT <br /> WAN JOAQUIN HEALTH DISTRICT <br /> 1601 E. HAZELTON AVE. <br /> COUNTY NAME STOCKTON, CA 95205 COUNTY # <br /> PHONE NO. 468-3423 <br /> SITE NAME: i 6t �' S,n _1 INSPECTION DATE: : -� <br /> SITE ADDRESS: /! tJ'' S r4, Dog,/.,/},-, CITY/STATE/Zn <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK �J rev TANK TANK -7, �TN K <br /> FORM A AND/OR B SUBMITTED? COMPUT,f ® COMPUTER COMPUT MPUTER <br /> TYPE INSP CTION SITE COMPUTER# NUMBEF�v'"' UMBEF�b) UMBE ©� MBER <br /> PER# ], PER# / `�/ PER# PER# <br /> vZoo1 U EXP DATE U XP.DATE K XP.DATE <br /> OPERATIONAL TANK TANK coNreNrs <br /> MAJOR MINOR <br /> PERMIT TO OPERATE 1 2 <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 -77 <br /> APPROVED CONSTRUCTION 5 6 <br /> WRITTEN MONITORING PROCEDURES 7 8 <br /> APPROVED MONITORING SYSTEM -LX 10 <br /> MONITORING SYSTEM 11 12 <br /> APPROVED MONITOR FREQUENCY 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 <br /> ACCESS CASING SECURED 17 18 -mm <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 34 <br /> SAFETY HAZARD 35 36 <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE migi ill <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 <br /> OWNER/OPERATOR MONITORING 144 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 155 156 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> MAJOR 7 MINOR 58 NO 59 <br /> ❑ <br /> VIOL. VIOL. LJVIOL. <br /> OFFICE: INSP• RECMB �- 7 tc,X <br /> TITLE: A&I 2 PHONE: � � � BECK: <br /> HUT-3 ORIGINAL 5/88 "" <br />