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UNDERGROUA TANK PROGRAM OFFICIAL INSP TION REPORT <br />SAN JOAQUIN HEALTH DISTRICT <br />1601 E. HAZELTON AVE. <br />rmlury UA ur STOCKTON, CA 95205 COIINTY # 9 <br />vvv..• • ..'....`Vcwi 'r— t <br />VHUNt NU. 4615-3423 <br />--- - •.r I <br />SITE NAME: �I <br />FLAMMABLE VAPORS REMOVED <br />40 <br />�� <br />INSPECTION DATE: <br />SITE ADDRESS: �a <br />Q�yr�L/yy <br />POWER DISCONNECTED <br />,� {, <br />CITY/STATE/ZIP SjCAVrYt/ 6:5� <br />CHANGES SITE/OWNER/PERMIT? <br />YES <br />NO <br />TANK d / <br />TANK Q.Z <br />TANK 0,3 TANK <br />FORM A AND/OR B SUBMITTED? <br />46 <br />47 <br />COMPUTER <br />COMPUTER <br />COMPUTER COMPUTER <br />FLAMMABLE VAPORS REMOVED <br />50 <br />NUMBER <br />NUMBER <br />NUMBER NUMBER <br />TYPE OF INSPECTION SITE COMPUTER # <br />53 <br />PER # <br />PER # <br />PER # PER # <br />156 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />SYSTEM STATUS (MUST MARK ONE) <br />—15 <br />EXP. DATE <br />EXP. DATE <br />EXP. DATE EXP. DATE <br />OPERATIONAL TANK <br />TANK CONTENTS <br />MAJOR MINOR NO <br />VIOL. ❑ VIOL. VIOL. ❑ <br />MAJOR MINOR <br />PERMIT TO OPERATE <br />1 <br />2m <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 lo <br />MONITORING RECORDS MAINTAINED <br />15 <br />16 <br />mµ_ <br />ACCESS CASING SECURED <br />17 <br />18 <br />PIPING <br />19 <br />20, <br />INVENTORY RECONCILIATION <br />21 <br />22 <br />A <br />l000l <br />TANK GAUGING <br />23 <br />2 <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 />_mm <br />UNAUTHORIZED RELEASES REPORTED <br />33 <br />34 <br />SAFETY HAZARD <br />35 <br />36 <br />__.a . _.._, �-- —. - —,.. •�,�...-..�.�__ <br />CONDITIONS ABATED <br />/ <br />37 <br />TEMPORARY TANK CLOSURE <br />REMOVAL OF RESIDUAL <br />38 <br />39 <br />FLAMMABLE VAPORS REMOVED <br />40 <br />�� <br />ACCESS LOCATIONS SEALED <br />41 <br />42 4 <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 />155 <br />156 <br />THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br />SYSTEM STATUS (MUST MARK ONE) <br />FOLLOWS: "' (p <br />57 58 <br />59 <br />MAJOR MINOR NO <br />VIOL. ❑ VIOL. VIOL. ❑ <br />OFFICE: I INSP: A ",_- , k,24 A,,f, I RECEIVED BY: <br />lwl Y ��y I PHONE: BECK: <br />Hl IT -3 <br />5/88 © m <br />