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.......... ---------- ......... ------- ----------- ----------- .....................-- ---- --------- ------- ------------ <br /> .......... ..................... .............. ...........---- ------ ....... ............ ................ .................. ............ .................. .................­_------------- ............ ................. <br /> SYSTEM INSTALLATION DOCUMENTA11ON FOR ENVIRONMENTAL HEALTH AND SAFETY <br /> GROUff, (PRQVIDE DOCUMENTS DIRECTLY TO 9H&S BEFORE 91-NAL) <br /> YES NO N/A <br /> E] <br /> 1. TLS-350 system installed and located per drawings, <br /> operational and properly configured. <br /> F] FF] 2. TLS-350 alarms have been tested and configured at their YES NO N/A State/ CUPA forms (formally A, B, and C) <br /> proper settings. F 1. New Installation projects: Originals to local agency, <br /> 0 0- L1 3. All tank manhole covers opened for inspection of tank copies to Environmental Health & Safety. <br /> equipment and sump penetrations. <br /> 4. Construction debris has been removed and the parking area 0 0 1:1 2. Modification/Instal lotion projects: Original to local <br /> cleaned and repaired satisfactorily. agency, copies to Environmental Consultant. <br /> E] 5. Damaged landscaping elements have been replaced or Underground Storage Tank Monitoring and Response Plans: <br /> F repaired. EJ F E] 1. Contact designated agent assigned by AT&T Environmental <br /> El L] 6. Standby engine has been successfully tested after new Health & Safety to prepare UST Monitoring and Response <br /> tank cut-over. Plans. <br /> F 7. Air and water reels located per drawings. (Fleet locations) PST System Certification & Testing Results: <br /> __] E] E] 1, Provide Copies of Tank Integrity Test Results to CUPA & AT&T <br /> F 8. Seal at the dispenser mount bracket/island interface. Environmental Health & Safety. <br /> 2. Provide copies of completed State Secondary Containment Testing <br /> 9. Emergency shut--off switch located per drawings. (Fleet locations) Report Forms to Cupa & AT&T Environmental Health & Safety. <br /> ._1 L I <br /> 10. Commodity togs installed on fill risers. 3. Provide copies of completed State Monitoring System Certification <br /> forms to CUPA and AT&T Environmental Health & Safety. <br /> F 11. Manholes properly crowned. <br /> 4. Place a copy of all reports in HMPPP Binder on site. <br /> 12. Field Inspection Final Acceptance Form signed by all parties, 5. Tank chart (from tank manufacturer) MANDATORY. <br /> El El 1___] L <br /> El E1:16. Perform Enhanced Leak Detection (ELD). Contact Tracer Reserch Corp. <br /> 13. TLS Records Box and appropriate labels. or other AT&T Environmental Health & Safety approved consultant to <br /> perform testing. <br /> 14. Applied EH&S furnished labels to TLS-350 panel. <br /> 7. Vereify that continuos monitoring is performed on all underground tanks, <br /> MANDATORY: sumps and piping. <br /> Mount tank chart copy and send original to <br /> EH&S for lamination. Closure Reports: <br /> 1. Manifests and triptickets, Certificates of Destruction, Compaction reports, <br /> etc. to Environmental Consultant for inclusion in Closure Report. <br /> ,5'ign below to indicate <br /> _qttend,ancq at Final Inspection; Sign again to indicate LIN <br /> AL_A_CLEPLANfE of work after Final <br /> Inspection (either in field if no remedial work needed, or after remedial work concluded 1:1 E] 2. Environmental Consultant to provide and mail copies of the closure report <br /> to AT&T Environmental Health & Safety. <br /> ATTENDANCE FINAL. ACCEPTANCE <br /> Facility Engineer <br /> Send one copy of all documentation <br /> Facility Manager within 30 days of completion of project to: <br /> Site Manager AT&T EH&S <br /> ....................... ........... ATTN: LARRY HARRELL <br /> Project Manager 308 SOUTH AKARDS TREET; ROOM 1700 <br /> ....... <br /> Contractor DALLAS, TX 75202 <br /> Consultant <br /> ............... <br /> Environmental Health & Safety <br /> CONSULTANT STAMP <br /> ........................ <br /> ---------...... ...................... ................. <br /> UTERATURE (To be placed in a ring binder by contractor, clearly identifying each item. <br /> Outside cover to show job location and date as per sheet P-1 of drawing <br /> set.) One binder to be stored on site, one sent to AT&T Environmental <br /> Health & Safety. <br /> nance Data <br /> YES No N/A (list materials received) <br /> F L-] 1. Tanks (Tank chart & drawing by Mfr.) <br /> 2. Sumps CONSULTANT STAMP <br /> El 1:1 1:1 3. Sensors <br /> SALAS O'BRUN <br /> EJ_ 4. Piping TENGINEERS, INC.IN"C <br /> 5. Pumps 305 south 11th Street <br /> San lase, <br /> 'A <br /> C -2218 <br /> 6. Double containment piping system 436 14th Str95112-eet, Suite 200 <br /> Oakland, CA 94612-2725 <br /> 7. Wells <br /> 498 Foam Street <br /> 8. Leak Detection Systems Monterey, CA 93940--1410 <br /> .0 (408) 282--1500 <br /> -6 9. Other: FAX: (408) 297-2995 <br /> El El El www.salasobrien.corn <br /> _J <br /> Permits and A enc, CQrrespondencq <br /> E RNSIONS / AUTHORIZATIONS <br /> YES NO N/A <br /> 12BY <br /> 0 Lj F�] D 10, Copies of signed permits (Health Care Agency, County or City Fire NO. REMM / MMMIZATIOWS DATE <br /> Iplicable) given <br /> 0 Departments and Building departments, etc. as op 80% ISSUED FOR CLIENT REVIEW 9/28/09 CSB <br /> 8 to AT&T Engineer <br /> Cli <br /> RESPONSE TO CLIENT COMMENTS 10/6/09 C'S B <br /> 0 <br /> z TRANSITION BOX ADDITION 10/13/09 CSB <br /> id YES NO N/A - <br /> E <br /> 11. Contractor has submitted accurately marked set of as-built drawings RESPONSE TO CLIENT COMMENTS/ADD VENT LINE SCOPE 11102109 CSB <br /> L-A <br /> _P to AT&T Engineer. <br /> .2B <br /> a. RESPONSE '10 COMMENTS (95%) 11/16/09 CS <br /> CUPA RESUBMITTAL_ 11/23/09 CSB <br /> PROPRIETARY AT&T INFORMATION <br /> NOT FOR GENERAI_ USE OR DISCLOSURE OUTSIDE OF AT&T <br /> UTl_ <br /> THIS INFORMATION MAY ONLY BE USED BY AJOR IZED <br /> PERSONNEI__ OF INE LOCAI.. GOVERNMENT AGENCY IN CONNECTION <br /> E <br /> WI-III APPLICATION FOR PERMITS AND AUTI­IORIZATIONS FOR <br /> BUII DINGS, CONSTRUCTION, AND/ OR ZONING CHANGES. <br /> DRAWINGS PREPARED FOR <br /> mm <br /> U_ <br /> N <br /> 0 at M CORPORATE <br /> REAL ESTATE <br /> PROJECT TTTLE: <br /> o STAMONY ffiMEN UFFAHOMS <br /> E <br /> 345 N. SAN JOAQUIN STREET <br /> ------------- ..................................... ........... ........................ .................. .................................... ........... ................ ---------- ------............... <br /> STOCKTON <br /> CA U S <br /> C <br /> 8z <br /> SKTNCA01 UE-042 <br /> SHEET TITLE: <br /> UNDERGROUND FUEL TANK <br /> a. SUCTION SYSTEM <br /> PROJECT CLOSE-OUT SHE,E_T <br /> Z C4 <br /> AT&T PROJECT NUMBER: DATE: 9/21/09 SCALE: AS NOTED <br /> '�o <br /> W CHECKED BY: CSB <br /> 751 07406:5: DRAWN BY: NDP <br /> AT&T AUTHORIZATION: <br /> lo- SHEET: 4 OF: 4 SHEETS SHEET NO. <br /> 12 Stantec Architecture Inc, ITel. 707.765.1 66Q AT&T DRAWING NO.: <br /> a: CL 1137 N. McDowell Blvd. I Fax.707.765.9908 AIAUDEFEEMN <br /> stanwcetalurno, CA U.S.A, 949541 www.stantec.com SK'TNO 1 -0 1 1109 <br /> F:\Prcoj'ect\V,- ,','-O--P\O-IFH\2007839028\DV,'GS\3-,Perir,it\2007839028-F4.dv,,g 1112312009 1D52 AM Brawn, Chris <br /> -------------- -------- ........ ---------------- ----------------------- -----------------­ -----_-_ ................ ---------- ------ <br /> ------------ <br />