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Tracy Mazda Waste Anti-_.zeze Tank and Waste Oil Assessment <br /> Written Assessment per CCR Title 22 <br /> Inspection Checklist and Notes <br /> Page i <br /> Integrity Assessment Inspection Checklist <br /> General Information <br /> Site Name: 1ft Facility Con t: Contact Tel No.: Date: <br /> . F. 7 <br /> Site Add�rr"�se,; Tank Contents: <br /> Street zip: <br /> Tank Id(if atsy} G Capacity: Vr Instal 1kME : Tank Model: <br /> �ds. 22iir�•t' <br /> `yank Configuration(long.dimen.) metniooa: <br /> Miloriznntal Vertical Rectangular Tanks: L; W; H: <br /> • <br /> Cylindrical Tanks: Lcn h: <br /> Secoadar_y Containment <br /> Tank:❑ Integral DW Tank❑Containment berm ❑ Controlled Drain/Sump/9 None <br /> �i <br /> Other(description)____ <br /> Piping:❑ Integral DW Piping❑Containment berm ❑ Co <br /> Draln/5ump 13 None <br /> Other(description)____ <br /> Tank Primary Containment Material ❑Steel ❑ Fiberglass OthcritbnFnWall Thickness,_ <br /> Tank Secondary Containment Material ❑Steel ❑ Fiberglass ❑ Other Wall Thickness OTone <br /> I e/ <br /> Piping Primary Containment Material ❑steel ❑ Fiberglass M other Diameter(in")Z <br /> Piping Secondary Containment Material 17 Steel ❑ fiberglass f Elthec�ll� ld <br /> meter(in.) __ ❑None <br /> (Description/Com menta: <br /> Other Equipment <br /> DI'urnp,Internal ttvpe,size) Pump,External(type,size) lL- <br /> 7Day Tank ❑Drain Table ❑filter Crush ❑Other 1 Electronic Monitor(MfW Model) I <br /> [Description/Comments: <br /> Dwg's Available? ❑ Vest3 No Is Tan male Building or Covered? look Test�011rym' <br /> in Avail? <br /> Dog u Yee❑ No ❑ Yes DoltT,_ <br /> . <br /> 9- <br /> Iliac La Ing <br /> Z,3 a 71wAccum <br /> Smoking ❑ Product Description _v M_ 2"''{amrdous Waste <br /> O Absent Start Date ❑ tIL Std No,___ ❑ other <br /> Strandberg Associates 1(866) 388-0404 (650) 329-8918 rwaterguyra rwaterquy.com 29 <br />