COMPLIANCE INFO_2010 - 2011 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN C NTY ENVIRONMENTAL HEAOH DEPARTMENT UST/PIPING CLOSURE INSPECTION FORM SITE NAME: CHEVRON #307709 SR#: 59375 ADDRESS: 10858 TRINITY PARKWAY CITY: STOCKTON OWNER NAME: CHEVRON PRODUCTS COMPANY PHONE: CONTRACTOR: TOWN & COUNTRY CONTRACTORS PHONE: FIRE PERMIT M TANK # 39 ® PIPING REMOVAL ❑ UST REMOVAL ❑ CLOSURE IN PLACE ❑ TEMPORARY CLOSURE INSPECTOR: GARRETT BACKUS DATE: 5/4/2010 R I RINSED: ❑ YES ®NO METHOD: AMOUNT: N RINSATE DISPOSAL SITE: S E MANIFEST M OTHER TRACKING M V A P PURGED: ❑ YES ® NO METHOD: AMOUNT USED: R READINGS AT REMOVAL: L.E.L.: 02: COMMENTS*: C TANK MATERIAL: ❑ STEEL ❑ FIBERGLASS ❑ OTHER TANK SIZE: 0 TANK CONDITION: ❑ GOOD ❑ POOR ❑ HOLES COMMENTS*: N S PIPE MATERIAL: ❑ STEEL ® FIBERGLASS ❑ OTHER TOTAL LENGTH OF PIPING: 20 feet total attached to UDCs T PIPE CONDITION: ® GOOD ❑ POOR ❑ HOLES COMMENTS*: DEPTH SOIL TYPE OBSERVATION* SAMPLE # T A N K EXCAVATION SIZE (length x width x depth): X X S DEPTH SOIL TYPE OBSERVATION* SAMPLE # A P 2 feet sandy loam sampled under six UDCs one per UDC M I P P L E I N TRENCH SIZE (length x width x depth): X X G H DEPTH TO GROUNDWATER: 8 ft # HOURS SINCE DEWATERING: 2 0 SAMPLING METHOD: OBSERVATION*: no water under UDCs STOCKPILE#1: Cubic Yards COVERED: ❑ YES ❑ NO SAMPLE # SAMPLE # STOCKPILE#2: Cubic Yards COVERED: ❑ YES ❑ NO SAMPLE # SAMPLE # OTHER SAMPLES: One sample under each UDC. UDCs removed only, no piping removed except to disconnect UDCs. LABORATORY: fiest*teriea�c. �/'� A -ham SAMPLER'S NAME: Marco Escobedo, Wayne Perry Inc. CLOSURE IN PLACE: BACKFILL MIXTURE: 7 VOLUME: SITE MAP ATTACHED**: ® YES ❑ NO EH 23-0043 (Rev 5/22/2007) IMPORTANT NOTES: Complete one form for each tank removed * Include all commentslobservations ** Site Map Required