Laserfiche WebLink
,1 -Al <br /> _ Ilrl!.grity Assessment Ins cction Checklist <br /> Geiveral Infor'ntation <br /> Site.'' ;tae: Fa i:]�W <br /> Contact Tel No.: Date: <br /> !/ .i cr�Sd <br /> Site Address: � � Tank Contents: �.. <br /> Street r' . �'/t>�� <br /> ' run ld ftfany9 f:ra. C'aPacit}: Y stalled: "Ta k Mfg!.; �� Tank Model: <br /> Tank Cron rguratutn(long.dimcn.) llinaerasions: - <br /> Itrctang;ular"tanks: L. W:�H:0...4 <br /> I larirota[al ❑Vertical tMinddiml Tanks; Length: Dram. <br /> Secondary Containment <br /> TankJJrttggrnl DW Ttsnl:El Containment t+enn ❑ Controlled DrainlSump © None <br /> Q Other Ocscriplion) <br /> Piping,: ❑ lateual DW Piping El Con[ainment berm ❑ Controlled DraintSump C7 None <br /> Other(dcscriptlon)__ C" fit/ �Igr�!r 7i <br /> 'I'auk Printnry Cranlainment Material Stec ❑ Fiberglass El Other Wall Thickocss_�- <br /> T'nnk 5rcondary Courulnment Nuterial CI 5ttel ❑ Fiberglass ❑ Other----Wali Thickness Q None <br /> "her Piping Primary Containment Material C1 Steel El riberglass her 1�Diameier(in.) �'` <br /> Piping 5econdat Con tatntnent Mtile rlal ❑Steel ❑ Fiher lass C] Othe /�r� Diaatteter in. ®None <br /> Dew ription/Comnaetill: <br /> __ <br /> Other Equipment <br /> I=lpuntp,Internal;type,sine) __ OPunap,F",xternal(type,size) <br /> ❑Day'fnnk C]Dnaln Table C1 Filter Crash ther CK.lectmnic MtonNnr(Mtfg/Model) c <br /> ur.criptionJ{:ranaments: � {'���_ s <br /> iDwg's Available; E7 Yes l No Is Tank Inside Building or Covered? Leak'i'est nr lnspectlon Avail? <br /> Dsv Yes Q No ❑ Yes❑ o If Yes,Datc <br /> Placard Labeling <br /> [ !'resent g C7 No Smoking f Product Description ----- �Fy Hazardous Waste <br /> l Absent YIIW Accum Start Date ❑ 1J1,Std No. l othrt <br /> Tracy Chrysler Jeep 16 Waste Anti-freeze Tank <br /> i <br />