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Time In. <br /> Time Out <br /> (,4,1 <br /> P +++�. - San Joaquin County ' <br /> .�soyEnvironmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> Telephone.(209) 468-3420 Fax:(209) 464-0138 Web:www siaov.ora/ehs.r AaMt <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: PLANT & Date: <br /> Address: TOR RD LO' 10 <br /> Requestor. .3�CIFIC PETROLEUM SE. Telephone <br /> Program Element: , ,Ub- USTRE-IRJFIT Request* SRdO aiu , <br /> Inspection Type: 'T <br /> RETROFIT REPF'' NS <br /> Onsite Service Technician Brad! ICC Service Tectllnstaller Exp. Date: 02'12 <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> c to witness the secondary containment tests of the two 87 product tanks. <br /> Both passed the 5psi test for one hour. <br /> A visual inspection inside the UDCs was conducted to verify that no leaks occur while fuel is being pumped. <br /> An inspection needs to be scheduled for the following: <br /> 1. Leak detector test on the 87 tank to verify it can pass the 3 gal./hr at 10 psi test. <br /> Remember to complete the following: <br /> Secondary containment testing on the repaired 87 product secondary piping is required six months after installation. Provide <br /> 48 hours notification to the EHD when this test is scheduled <br /> Log into the California Environmental Reporting System(CERS), update as necessary and submit the"UST Monitoring Plan'" <br /> for the 87 tank for approval. <br /> Log into the California Environmental Reporting System(CERS), complete and submit a"UST Certification of <br /> installation/Modification"form for the repaired 87 product secondary containment pipe within 30 days. <br /> The person in charge is responsible for ensuring that the above mentioned facility is in compliance with all applicable sections of the California Health and <br /> Safety Code. If a reinspection is required,fees will be assessed at the current hourly rate. <br /> Received by: Name and Title: Mike E. Cardlock Mar,:. <br /> EH Specialist: Phone: <br /> FA0005584 SR0074101 SC298 02/052016 <br /> EHD 23-01 Rev.0630115 �1 ,j- Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />