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Time In: <br /> Time Out: <br /> o� uta San Joaquin County <br /> L' Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> Telephone.(209)468-3420 Fax:(209)464-0138 Web:www.siaov.ora/ehd <br /> 4C/PC'AN <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: Date: <br /> Address: <br /> Requestor Telephone <br /> Program Element: Request#: <br /> Inspection Type: <br /> Onsite Service Technician ICC Service TecNlnstaller Exp. Date: <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness the hydrostatic test of the racing fuel fill spill container and verify that it can hold at least five gallons of liquid <br /> It passed the one hour lake test and can hold at least five gallons. <br /> Witnessed the functionality testing of the racing fuel fill spill container drain. It passed the functionality test. <br /> Witnessed the measurement of the racing fuel overfill prevention drop tube with mechanical Flapper set at95% overfill. <br /> The technician measured the drop tube and demonstrated that it was cut at the proper length to achieve overfill prevention at <br /> no greater than 950/o capacity of the tank. <br /> The secondary containment of the racing fuel tank was tested at97 inches of water column for one hour. Technician confirmec <br /> that 27.7 inches of water column equals one psi. Therefore 97 inches of water column equa13.5 psi. The gauge did not changE <br /> position for the one hour secondary containment test of the racing fuel tank annular space. <br /> All pass.The racing fuel tank may receive fuel. <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 . Ins s the current hourly rate. <br /> Received by: / <br /> Name and Title: <br /> EH Specialist: Phone: <br /> FAD003771 SR0073835 SC298 01272016 <br /> EHD 2301 Rev.06/30115 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />