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Ross Robert Truck Repair Waste Antifreeze Tank Interim Assessment and Conditional Certification September 18,2021 AST Integrity Assessment Inspection Checklist Tank Inspector Nancy Rebholtz Cert#: AST-6710 Site Name: Ross Facility Contact: Contact Tel No.: Date: 7/20/2021 Roberts Truck Repair Dan Payne Site Address: Tank Contents: Street 641 S. Harrison St City: Stockton Zip:_95206 Waste Antifreeze Tank Id(if any) Gross Capacity: Yr Installed: Tank Mfg.: Tank Model: Appr. 100 gal Unknown Unknown Unknown Previous Formal Inspections ® No ❑Yes ❑Unknown Date: Type: ❑Internal ❑External Copy of Prior Inspection Available?: ❑Yes ®No Owner Annual Inspections Review Owner Annual Inspections Review Copy of Inspection Available?: ❑Yes ®No Copy of Inspection Available?: ❑Yes ®No Operating Inspection Frequency ❑Annually ❑Monthly ❑Weekly ®Daily ❑Per Shift Recorded ❑Yes ❑No Tank Configuration(long. dimen.) Dimensions: Rectangular Tanks: L: W: H: ❑ Horizontal ® Vertical Cylindrical Tanks: Height: 36" Diam. 35"upper,24: lower Industry Standard(Fabrication&Nameplate Data) ❑UL 142 ❑UL 2085 ❑ UL 80 ❑ API 650 ❑ Other ®Not Determined Nameplate Shell Thickness: N/A in. Bottom Thickness: in. Shell Thickness: Dwg's Available? ❑Yes ®No Is Tank inside Building or Covered? Leak Test or Inspection Avail? Dwg ®Yes ❑No ❑Yes ®No If Yes,Date_ Overall Tank System Condition: ❑Good ®Fair ❑Poor_ Adequate? (if no, explain) ®Yes ❑No See 7.1 Recommendations Tank Primary Tank Material ❑Steel Ll Fiberglass ®Other HDPE Wall Thickness Basis: ❑UT ❑Spec ❑UL Secondary Containment ❑Integral DW Tank ®Containment berm Dimensions: 47"x 235"x a minimum of 8"high ❑Controlled Drain/Sump ❑None El Other(description) could not determine if this is double walled tank Liquid in Secondary Containment?: ❑Yes MNo If Yes,contents: Secondary Containment Material ❑Steel ❑Fiberglass MOther HDPE ❑None Wall Thickness_ Secondary Containment Condition ❑Good ®Fair ❑Poor Holes/cracks? ❑Yes MNo Degraded integrity? ❑Yes NNo Corrosion? ❑Yes MNo Paint Failure? ❑Yes MNo Secondary Containment Drain Valve ❑Good ❑Fair ❑Poor MNo Valve Adequate?(if no,explain) MYes ❑No How is Tank Level Determined? ❑ Electronic ❑Mechanical Tank Gauge Testing—Level Gauge ❑ Dipstick ❑ Sight Glass M Other Visual:Plastic,translucent Tank ❑ Pass ❑ Fail M Not Tested Level Gauge Operational? ❑ Yes ❑ No M N/A High Level Alarm EJ Yes M No If yes, El Audible El Visual Testing—High Level Alarm ❑ Pass El Fail ® Not Tested Description/Make/Model/Comments: Overfill Prevention ❑ Present ❑x Absent Testing Overfill Valve Installed: ❑ Yes M No ❑ Pass ❑ Fail ❑ Not Tested High Level Alarm Triggers Shutoff? ❑ Yes ❑ No 4 H:TROP-PRl\21-061-00 Ross Robert Track Repair Title 22\Deliverable\Antifreeze report\Ross Roberts Antifreeze Assessment 2021 0720.docx