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R E C E I VE1 D <br />Attachment 5 OCT 2 3 2017 <br />TANK INSPECTION CHECKLIST <br />Page 2 of.4 ENVIRONMENTAL HEALTH' <br />FACILITY NAME: j/'��% 494/'' ,�p�j" <br />IDEPARTM <br />FACILITY LOCATION: SJ Y9 SSG /?J ✓� -�, �S 3 2 <br />INSPECTION DATE: G! Z 9 • / 7 <br />4.0 <br />Signs of spills or leaks from tank or associated piping? ❑ Yes <br />la'No ❑ NA' <br />4.1 <br />Has the facility had any major spills? ❑ Yes <br />ZNo ❑ NA <br />4.2 <br />Contaminant of concern in major spill? <br />4.3 <br />Is the soil contaminated? ❑ Yes <br />❑ No �1 NA <br />4.4 <br />Contaminant of concern in soil? <br />4.5 <br />Is the ground water contaminated? []Yes <br />❑ No U NA <br />4.6 <br />Contaminant of concern in ground water? <br />• 4.7 <br />Is there aground. water monitoring system? ❑ Yes <br />ONO ❑ NA <br />4.8 <br />Number of monitoring wells? <br /> <br /> <br />4.10 <br />Frequency of monitoring? ❑ Daily Vf Weekly ❑ Monthly ❑ Other: <br />5.0 <br />Ongoing cleanup? ❑ Yes <br />❑ No O NA <br />5.1 <br />Organization doing cleanup? Facility: ❑ Yes ❑ No <br />Outside Group: ❑ Yes ❑ No If yes, identify group: <br />5.2 <br />Ongoing investigation? ❑ Yes <br />❑ No NA <br />5.3 <br />Which agency is acting as lead for cleanup? Facility: ❑ Yes ❑ No <br />Outside Group: ❑ Yes ❑ No if yes, identify group: <br />5.0 <br />Has the SWRCB ever inspected the site? ❑ Yes ❑ No If yes, date: <br />6.1 <br />Name of SWRCB contact person? . <br />6.2 <br />Has the -EPA ever inspected the site? ❑ Yes ❑ No If yes, date: <br />6.3 <br />Name of EPA contact person? <br />7.0 <br />Is the SPCC Plan available during working hours? 111 Yes ❑ No <br />7.1 <br />Discuss any questions from your review of the SPCC Plan: <br />BACCI 602.DBC-Z22-TRACY <br />