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SYSTEM INSTALLATION DOCUMENTATION FOR ENVIRONMENTAL YES No N/A MANAGEMENT GROUP ❑ ❑ ❑ 1. TLS-350 system installed and located per drawings, operational and properly configured. ❑ ❑ ❑ 2. TLS-350 alarms have been tested and configured at their YES NO N/A State/ CUPA forms (formally A, B, and C) proper settings. ❑ ❑ ❑ 1. Removal/Installation projects: Original to local agency. ❑ ❑ EJ 3. All tank manhole covers opened for inspection of tank copies to Environmental Consultant for closure report. equipment and sump penetrations. Copies to Environmental Management ❑ ❑ ❑ 4. Construction debris has been removed and the parking area ❑ ❑ ❑ 2. New Installation projects: Originals to local agency, cleaned and repaired satisfactorily. copies to Environmental Management. ❑ ❑ ❑ 5. Damaged landscaping elements have been replaced or Underground Storage Tank Monitoring Plans: repaired. ❑ ❑ ❑ 1. Contact designated agent assigned by SBC ❑ ❑ ❑ 6. Standby engine has been successfully tested after new Environmental Management to prepare UST Monitoring and tank cut-over. Response Plans. ❑ ❑ ❑ 7. Air and water reels located per drawings. (Fleet locations) Spill Prevention, Control, and Countermeasure Plans: ❑ ❑ ❑ 1. Contact designated agent assigned by SBC nvironmental Management to prepare SPCC plan if required. ❑ ❑ ❑ 8. Seal at the dispenser mount bracket/island interface. All above ground tanks over 660 gallon capacity, or IJSTs with total aggregate capacity over 42,000 gallons.) ❑ ❑ ❑ 9. Emergency shut-off switch located per drawings. (Fleet locations) Tank Testing Results: E] ❑ F1 10. El El 1. Provide test results to local agency and SBC 10. Commodity tags installed fill risers. Environmental Management. Closure Reports: ❑ ❑ ❑ 11. Manholes properly crowned. ❑ ❑ ❑ 1. Manifests and triptickets, Certificates of Destruction, Compaction reports, etc. to Environmental Consultant for inclusion In Closure Report. ❑ ❑ ❑ 12. Field Inspection Final Acceptance Form signed by all parties. ❑ ❑ ❑ 2. Environmental Consultant to provide and mail copies of the closure report to SBC Environmental Management. ❑ ❑ ❑ Tank Chart (from Tank mfr.) Send one copy of all documetation to: SBC Service, Inc. Environmental Management 2600 Camino Ramon, Room 3E OOT San Ramon, CA 94583 LRERATURE (To be placed in a ring binder by contractor, clearly identifying each item. Sign below to indicate attendance at Fina/ Inspection; Sign again to Indicate FINAL ACCEPTANCE of work over f7hat Outside cover to show job location and date as per sheet P-1 of drawing inspection (&4ho, In Neid If no remedial work needed, or after remedial work concluded. set.) One binder to be stored on site and one sent to SBC Environmental 4D A Management. ATTENDANCE FINAL ACCEPTANCE A. Manufacturers Warranty. Operation Manual/Maintenance DataF Facility Engineer YES No N/A (list materials received) Facility Manager } cv:•. 3c E] E] E] 1. Tanks (Tank chart & drawing by Mfr.) #C 9291 Site Manager SF 0 7 At 2. Sumps ❑ ❑ ❑ Project Manager IcOF CAL1FQQi� . ; E E] ❑ ❑ 3. SensorsContractor ❑ ❑ ❑ 4. Piping E] E] ❑ 5. Pumps Consultant REVISIONS / AUTHORIZATIONS S Environmental Management o ❑ ❑ ❑ 6. Double containment piping system NO. REVISIONS / AUIHORInTIONS DATE er n ❑ ❑ ❑ 7. Wells SUBMITTED FOR PERMIT 7/17/01 MED ❑ ❑ ❑ 8. Leak Detection Systems T CHANGE UNDERGROUND PIPING SPECIFICATION 8/29/01 MED o ❑ ❑ ❑ 9. Other: o B. Permits and Agency Correspondence PROPRIETARY SBC INFORMATION YES NO N/A NOT FOR GENERAL USE OR DISCLOSURE OUTSIDE OF SBC ❑ ❑ ❑ 10. Copies of signed permits (Health Care Agency, County or City ENVIRONMENTAL MANAGEMENT UNDER EXEMPTIONS SET FORTH IN Fire Departments and Building departments, etc. as applicable) THE CALIFORNIA PUBLIC RECORDS ACT. THIS INFORMATION MAY given to SBC Engineer ONLY BE USED BY AUTHORIZED PERSONNEL OF THE LOCAL 0 GOVERNMENT AGENCY IN CONNECTION WITH APPLICATION FOR a PER ITS AND AUTHORIZATIONS FOR BUILDINGS, CONSTRUCTION, E C. Test Results AND OR ZONING CHANGES. YES NO N/A DRAWINGS PREPARED FOR ❑ ❑ ❑ 11. Fuel tests on flue[ transferred from old underground storage tank ( 0 (D)EWIRONMENTAL MANAGEMENT ❑ ❑ ❑ 12. Integrity Tank and Piping test results (TANKNOLOGY) N E] E] F113. Test results sent to A.Q.M.D. - (Fleet Sites) & Environmental Management, PACIFIC REGION 0 i ❑ ❑ ❑ 14. All test results given to SBC Environmental Management '' E PACIFIC BELL FACILITY e D. As-Built Documentation YES No N/A 124 W. ELM STREET n a ❑ ❑ ❑ 15. Contractor has submitted accurately marked set of as-built drawings LODI, CALIFORNIA to SBC Engineer. LODICA01 UE020 Ne %O SHEET TIRE: " 0 STAND-BY GENERATOR SUCTION SYSTEM Y� PROJECT CLOSE-OUT CHECK SHEET V ESTIMATE/ ROUTINE ORDER: DATE 2/26/01 SCALE AS NOTED a DRAWN BY: SEW CHECKED W. MED i ARCBITSCIIM • HNGA�tII'iG ' HN ONI�91 SRRVICRR SBC Au HomAnaN: SNEET: 6 OF.- 8 SHEETS SHEE No. 1137 N. McDOWELL BLVD. PETALUMA, CA 94954 (707) 765-1660 SVC DRAWING NO.: am9e DTC JOHN A JOHNSON, ARCHITECT JAMES H. RAY, CINL ENGINEER P8 J