REMOVAL_2014 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT UST/PIPING CLOSURE INSPECTION FORM SITE NAME: SJ REGIONAL TRANSIT SR#: 0068638 ADDRESS: 1533 E. LINDSAY CITY: STOCKTON OWNER NAME: SJ REGIONAL TRANSIT PHONE: 467-6671 CONTRACTOR: TERRACO (SR REQUESTOR) / JIM THORPE (REMOVAL) PHONE: 847-906-5019 FIRE PERMIT #: COS FIRE DEPART 1-13-14 TANK # 39 580115814 ® PIPING REMOVAL ® UST REMOVAL ❑ CLOSURE IN PLACE ❑ TEMPORARY CLOSURE INSPECTOR: JEFFREY WONG DATE: 3/4/2014 R RINSED: E)�YES ❑ NO METHOD: fC,& �r �Q —�vrl AMOUNT: I N RINSATE DISPOSAL SITE: I S E MANIFEST M OTHER TRACKING #: V A P PURGED: ❑ YES ❑ NO METHOD: r AMOUNT USED: a L.E.L.: 02: COMMENTS*: C: ❑STEEL ®FIBERGLASS ❑OTHER TANK SIZE: 6000 (New Oil,0 ffREADINGSEMOVAL: N: ❑ GOOD ❑ POOR ❑ HOLES COMMENTS*: S ❑ STEEL 0 FIBERGLASS ❑ OTHER I TOTAL LENGTH OF PIPING: T PIPE CONDITION: ❑ GOOD ❑ POOR ❑ HOLES COMMENTS*: DEPTH SOIL TYPE OBSERVATION* SAMPLE # T Oar ;51-A -Itllika N A 1 a1 h r is a t sy\ N K EXCAVATION SIZE (length x width x depth):(n f� C 3 4 X Z.X t S DEPTH SOIL TYPE OBSERVATION* SAMPLE # A P C' m a do (s "o o F3 M I P P L E NTRENCH SIZE (length x width x depth): 35 X T X 2' C�* � P?t t0 Corner JV4f S G H DEPTH TO GROUNDWATER: ft # HOURS SINCE DEWATERING: 2 0 SAMPLING ETHOD: OBSERVATION*: STOCKPILEa� �C) Cubic Yards COVERED: ❑ YES []NO SAMPLE# AMPLE# STOCKPILE Cubic Yards COVERED: ❑ YES ❑ NO SAMPLE # SAMPLE # g, c lab OTHER SAMPLES: LABORATORY: Argon SAMPLER'S NAME: Groundzero CLOSURE IN PLACE: BACKFILL MIXTURE: VOLUME: SITE MAP ATTACHED**: YES ❑ NO EH 23-0043 (Rev 5/2212007) IMPORTANT NOTES: Complete one form for each tank removed * Include all commentslobservations ** Site Map Required