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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALYH DEPARTMENT UST/PIPING CLOSURE INSPECTION FORM SITE NAME: SJ REGIONAL TRANSIT SR#: 0068638 ADDRESS: 1533 E. LINDSAY CITY: STOCKTON OWNER NAME: SJ REGIONAL TRANSIT PHONE: 467-6671 CONTRACTOR: TERRACO (SR REQUESTOR) / JIM THORPE (REMOVAL) PHONE: 847-906-5019 FIRE PERMIT #: COS FIRE DEPART 1-13-14 TANK # 39 580115818 ❑ PIPING REMOVAL ® UST REMOVAL ❑ CLOSURE IN PLACE ❑ TEMPORARY CLOSURE INSPECTOR: JEFFREY WONG DATE: 3/4/2014 R I RINSED:YES 0 N it METHOD: bFORtE AMOUNT: N RINSATE DISPOSAL SITE: EMANIFEST #: Bei 2-;'6 3� 0 OTHER TRACKING M V A P PURGED: ❑YES ❑ NO METHOD: Y) Y j .4 C AMOUNT USED: 360 I b R READINGS AT REMOVAL: L.E.L.: 02: COMMENTS*: C TANK MATERIAL: ❑ STEEL ® FIBERGLASS ❑ OTHER TANK SIZE: 20,000 (Diesel) 0 TANK CONDITION: ❑ GOOD ❑ POOR ❑ HOLES COMMENTS*: N S PIPE MATERIAL: ❑ STEEL FIBERGLASS ❑ OTHER TOTAL LENGTH OF PIPING: T PIPE CONDITION: ❑ GOOD ❑ POOR ❑ HOLES COMMENTS*: GW6,j e{' Yid ktd d � DEPTH SOIL TYPE OBSERVATION* SAMPLE # T rlj�cc&Ler--.�t r A C odor- / 01 S n No CI'SdQr K EXCAVATION SIZE (length x width x depth): Pq X "X f S DEPTH SOIL TYPE OBSERVATION* SAMPLE # A P M I P P L E I N / 'w��, TRENCH SIZE (length x width x depth): X X 114 ►4r ck 4&C d d o�1 c* C 6X6Ft& G H TH TO GROUNDWATER: ft #HOURS SINCE DEWAT RING: 2 p [SAMPLINGMETHOD: OBSERVATION*: STOCKPILEff 50 Cubic Yards COVERED: ❑ YES []NO SAMPLE # 5eZ( SAMPLE # 5? ZZ- <,1 Z 3 ,SP STOCKPILE ublc Yards COVERED: ❑ YES [-]NO SAMPLE # SAMPLE # lab SAMPLES: LOTHER l LABORATORY: Argon SAMPLER'S NAME: Groundzero d h �Rg CLOSURE IN PLACE: BACKFILL MIXTURE: VOLUME: SITE MAP ATTACHED**: ES ❑ NO EH 23-0043 (Rev 5/22/2007) IMPORTANT NOTES: Complete one form for each tank removed *Include all commentslobservations **Site Map Required 1)