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Hazardous Waste Tank System <br />Written Assessment per CCR Title 22 <br />Stockton CSMS. Stockton. CA <br />Inspection Notes <br />ZI z� I �- <br />I'aee 1 Uri <br />Integrity Assessment Inspection Checklist <br />General Information <br />Site Name: <br />on► <br />FacilityContact: Contact Tel No.: <br />4tosv do <br />Date: <br />ck <br />Site Address: <br />f Stet <br />Tank Contents• <br />i <br />Tank ld (if an2l Gacity: Yr Installed: Tank lvtfg.: Tank Model: <br />ros <br />Ic c i A- l i7 <br />i <br />Tank Configuration (long. dime".) Dimensions: <br />Rectangular Tanks: L:_ H: _ <br />❑llorizontal Kvertical <br />C'rlindrical Tanks: Lent iam. <br />Secondan Conlainment <br />Tank: Integral DW lank Cl Containment berm ❑ Controlled Drain?Sump ❑ None <br />❑ Other Ideseription) <br />Piping: ❑ Integral DW Piping ❑ Contaimncnt berm ❑ Controlled Drain Sump L� None <br />❑ Other(description) 4je- A Z s I,�,- <br />Tank Primary Containment Material Steel ❑ Fiherglass ❑ OtherWall Thickness__ �% <br />t <br />I <br />Tank Secondarn Containment %lattrial / Stecl ❑ Fiberglass ❑ Other Wall Thickness!11fo None <br />I <br />Piping; Primas Containment Material Steel ❑ Fiberglass ❑ Other Diameter (in.) A ' <br />f <br />Piping Secondary Containment Material ❑ Steel ❑ FibcrglassOther _ Diarneter(in.)_ ❑ <br />Description/Comments:___ _ <br />Other Equipment <br />pp <br />❑Pump. Internal (type, size) Pump, External (type, size) -- <br />ize)—❑Day <br />I <br />0 DayTank ❑Drain Table ❑Filter Crush ❑Ocher _ ❑ Electronic Monitor (Mfgi Model) <br />Description/Com menta: <br />s <br />Dwg's Available? 13 YeNo <br />Is Tank inside Building or Cocerrd'' <br />Leak Te%1 or Insptcliun Avail? <br />Dw R <br />❑ Yes No <br />❑ Yc No If Yes, !):ue <br />fN <br />Placard Labeling µ <br />C3 Present ❑ Vo Smoking Product Description _ liarardou Waste <br />Absent AMAW Accum Start Date 6P UL Std No U Ruler <br />-= OTIE <br />Strandberg Associates 1(866) 388-0404 (650) 329-8918 rwaterquyPrwaterquy.com A-1 <br />