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SAN JOAQUIN COUNTY ENVIRONMENTAL HEAPH DEPARTMENT <br />UST/PIPING CLOSURE INSPECTION FORM <br />SITE NAME: SJ REGIONAL TRANSIT SR#: 0068638 <br />ADDRESS: 1533 E. LINDSAY CITY: STOCKTON <br />OWNER NAME: SJ REGIONAL TRANSIT PHONE: 467-6671 <br />CONTRACTOR: TERRACO (SR REQUESTOR) / JIM THORPE (REMOVAL) PHONE: 847-906-5019 <br />FIRE PERMIT #: COS FIRE DEPART 1-13-14 TANK # 39 580115816 <br />® PIPING REMOVAL ® UST REMOVAL ❑ CLOSURE IN PLACE ❑ TEMPORARY CLOSURE <br />INSPECTOR: JEFFREY WONG DATE: 3/4/2014 <br />R <br />I <br />RINSED: 56YES [:]NO <br />METHOD: DB=, "r: _ J ,Se <br />AMOUNT: 1-J Q k C <br />N <br />RINSATE DISPOSAL SITE: <br />E <br />A <br />7Pv <br />MANIFEST M o ZK�� OTHER TRACKING #: <br />PURGED: YES ❑ NO METHOD: rq ��� <br />AMOUNT USED: <br />a <br />READINGS AT REMOVAL: <br />L.E.L.: 02: COMMENTS*: <br />C <br />TANK MATERIAL: ❑ STEEL ® FIBERGLASS ❑ OTHER <br />TANK SIZE: 20,000 (Diesel) <br />0 <br />TANK CONDITION: GOOD ❑ POOR ❑ HOLES COMMENTS*: <br />N <br />S <br />PIPE MATERIAL: ❑ STEEL [FIBERGLASS ❑ OTHER <br />TOTAL LENGTH OF PIPING:t <br />T <br />)r <br />PIPE CONDITION: ❑ GOOD ❑ POOR ❑ HOLES COMMENTS*: Crl 0- Y2Juctl�d � ;4A,, d -CMO <br />DEPTH <br />SOIL TYPE <br />OBSERVATION* <br />SAMPLE # <br />T <br />�i t%4 1, <br />60 O by 74f k <br />-T 2^ In% <br />A <br />l <br />S' <br />N o a4 -v-- ucd d <br />"` <br />N <br />tjo0jjr ZaI iSColor,\ ie -A <br />K <br />EXCAVATION SIZE (length x width x depth): qJ' X st X <br />` <br />S <br />DEPTH <br />SOIL TYPE <br />OBSERVATION* <br />SAMPLE # <br />A <br />P <br />M <br />I <br />P <br />P <br />L <br />E <br />I <br />N <br />TRENCH SIZE (length x width x depth): X X N e pro cm CoEk <br />G <br />H <br />DEPTH TO GROUNDWATER: ft <br /># HOURS SINCE DEWATERING: <br />2 <br />0 <br />SAMPLING METHOD: <br />OBSERVATION*: <br />STOCKPILE Cubic Yards COVERED: ❑YES ❑NO SAMPLE# i3$AMPLE# p // <br />STOCKPILECubicYards COVERED: ❑YES ❑NO SAMPLE# SAMPLE# lab <br />OTHER SAMPLES: <br />LABORATORY: Argon SAMPLER'S NAME: Groundzero �L <br />CLOSURE IN PLACE: <br />BACKFILL MIXTURE: <br />VOLUME: <br />SITE MAP ATTACHED**: ES ❑ NO <br />EH 23-0043 (Rev 5/22/2007) IMPORTANT NOTES: Complete one form for each tank removed <br />* Include all commentsiobservations **Site Map Required <br />0 <br />