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SYSTEM INSTALLATION DOCUMENTATION FOR ENVIRONMENTAL MANAGEMENT GROUP. (PROVIDE DOMMENTS DIRECTLY TO EMCC BEFORE FINAL) YES No N/A ❑ ❑ ❑ 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. New Installation projects: Originals to local agency, ❑ ❑ ❑ 3. All tank manhole covers opened for inspection of tank copies to Environmental Management. equipment and sump penetrations. ❑ ❑ ❑ 4. Construction debris has been removed and the parking area ❑ ® ❑ 2. Modification/installation projects: Original to local cleaned and repaired satisfactorily. agency, copies to Environmental Consultant. ❑ ❑ 5. Damaged landscaping elements have been replaced or Underground Storage Tank Monitoring and Response Plans: repaired. ❑ ❑ ® 1. Contact designated agent assigned by SBC Environmental ❑ ❑ ❑ 6. Standby engine has been successfully tested after new Management to prepare UST Monitoring and Response Plans. tank cut-over. ❑ ❑ ❑ 7. Air and water reels located per drawings. (Fleet locations) PST System Certification & Testing Results: ❑ ❑ ❑ 1. Provide Copies of Tank Integrity Test Results to CUPA & SBC ❑ ❑ ❑ 8. Seal at the dispenser mount bracket/island interface. Environmental Management. (Not required on installs after July 1, 2003). ❑ ❑ ❑ 2. Provide copies of completed State Secondary Containment Testing ❑ ❑ ❑ 9. Emergency shut-off switch located per drawings. (Fleet locations) Report Forms to Cupa & SBC Environmental Management. ❑ ❑ ❑ 10. Commodity tags installed on fill risers. ❑ ❑ ❑ 3. Provide copies of completed State Monitoring System Certification forms to CUPA and SBC Environmental Management. ❑ ❑ ❑ 11. Manholes properly crowned. ❑ ❑ ❑ 4. Place a copy of all reports in HMPPP Binder on site. ❑ ❑ ❑ 12. Field Inspection Final Acceptance Form signed by all parties. ❑ ❑ ❑ 5. Tank chart (from tank manufacturer) MANDATORY. 6. Perform Enhanced Leak Detection (ELD). Contact Tracer Reserch Corp. ❑ ❑ ❑ 13. TLS Records Box and appropriate labels. ® ® ❑ or other SBC Environmental Management approved consultant to perform testing. ❑ ❑ ❑ 14. Applied EMCC furnished labels to TLS--350 panel. Closure Reports: MANDATORY. ❑ ❑ ❑ 1. Manifests and triptickets, Certificates of Destruction, Compaction reports, Mount tank chart copy and send original to etc. to Environmental Consultant for inclusion in Closure Report. EMCC for (amination. ❑ ❑ ❑ 2. Environmental Consultant to provide and mail copies of the closure report to SBC Environmental Management. Sign below to indicate attendance at Final Inspection; Sign again to indicate FINAL ACCEPTANCE of work after Fina/ Inspection (either in t<eld if no remedial work needed, or offer remediol work concluded. Send one copy of all documentation to: ATTENDANCE FINAL ACCEPTANCE SBC Service, Inc. Facility Engineer Environmental Management Facility Manager 2600 Camino Ramon, Room 3E000 San Ramon, CA 94583 Site Manager Project Manager Contractor Consultant Environmental Management LITERATURE (To be placed in a ring binder by contractor, clearly identifying each item. Outside cover to show job location and date as per sheet P-1 of drawing set.) One binder to be stored on site and one sent to SBC Environmental Management. 8. an f c u er's Warrgaty, Operation Manual Maintenance Data YES No N/A (list materials received) E] ❑ ❑ 1. Tanks (Tank chart & drawing by Mfr.) ❑ ❑ ❑ 2. Sumps LSW1 V 046 ❑ ❑ ❑ 3. Sensors ❑ ❑ ❑ 4. Piping REVISIONS / AUTHORIZATIONS ❑ ❑ ❑ 5. Pumps NO. REVISIONS / AURMZAnM DATE BY ❑ ❑ ❑ 6. Double containment piping system �0 MASTER DRAWINGS 3/4/03 ❑ ❑ ❑ 7. Wells 1 PER CLIENT INSTRUCTIONS 11/12/03 DM ❑ ❑ ❑ 8. Leak Detection Systems UPDATED TO 01/23/04 STANDARDS 2/23/04 DW ❑ ❑ ❑ 9. other: PROPRIETARY SBC INFORMATION B. Permits and Agency Correspondence NOT FOR GENERAL USE OR DISCLOSURE OUTSIDE OF SBC YES No N/A THIS INFORMATION MAY ONLY BE USED BY AUTHORIZED PERSONNEL OF THE LOCAL GOVERNMENT AGENCY IN CONNECTION WITH APPLICATION FOR ❑ ❑ ❑ 10. Copies of signed permits (Health Care Agency, County or City Fire PERMITS AND AUTHORIZATIONS FOR BUILDINGS, CONSTRUCTION, AND/ OR Departments and Building departments, etc. as applicable) given ZONING CHANGES. to SBC Engineer DRAWINGS PREPARED FOR Q. An-Quilt Do ati n YES NO N/A CORPORATE ❑ ❑ ❑ 11. Contractor has submitted accurately marked set of as--built drawings MA 0 REAL ESTATE to SBC Engineer. PROJECT Tiff.£: ESCALON a 1812 COLEY AVENUE ESCALON, CALIFORNIA CLLC=ESCLCAl 1 UG---010 SHEET Tfil.E: UNDERGROUND FUEL TANK SUCTION SYSTEM PROJECT CLOSE---OUT CHECK SHEET ENGAGEMENT NUMBER: [TATE. 09/16/03 SML- AS NOTED CONSULTING ENGINEERS DRAWN BY. DW CHECKED BY. TP 2880 Sunrise Boulevard SBC AUTHORIZATION: SHEET: 8 OF. 8 SHEETS SHEET N0. �- Suite 206 SBC Rancho Cordova, CA 95742 DItAM4NG NO.: (916) 635-2444 F8 TAIT & ASSOCIATES, INC. (916) 635--2606 Fax