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Sunday, June 15, 2008 8:08 AM HMC-Henderson Maint Co(209)465-4988 p.02 <br /> SAN JOAQUIN COUNTY <br /> ["NVIIZONMP..NTAI,-I-lr--.AL-TI i DEPARTMENT <br /> 600 Fast Main Street,Stockton,CA 95202-3029 <br /> Telephone. (209)468-3420 Fax--(209)468-3433 Web:www.sjgov.or'4/c11d <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br /> Faciliv Nx e; Inspection Dzte-- <br /> Facility Address: Service Requtst 4.- <br /> Onsite Service Technician's Name; ICC Service Techniciau/Ins(aller Certification#e Manufacturer Training; <br /> SERVICE SF-RVICF <br /> Leak detector Spill bucket 0 minimum 5 gallon <br /> El n-icebanical Model: 1:. <br /> 0 electronic serial ,M71 1'hour hydrostatic El Incon TS-STS <br /> El.cutd"Y.01 system E] Other <br /> F-1 line test progr mmed <br /> Leak dewctnr Spill bucket El minimum 5 gallon <br /> El mechanical Model: El El I hour hydrostatic El !neon TS-STS <br /> El electronic Serial #. El Caldwell System El Othor <br /> 0 line test programmed <br /> - Leak detector <br /> Spill bucket El minimum 5 gallon <br /> L 1:1 Mechanical Model, ❑ 0 1 hour hydrostatic F-1 Incon.TS-STS <br /> L1 electronic Serial tt: El Caldwell System El Other <br /> El line test programmed <br /> sensor Q positive shutdown Modcl: Primary piping testing at: <br /> El El <br /> [I fail safe Serial tt: psi <br /> Cl NA minutc.% <br /> sensor Secondary piping testing at: <br /> 0 Positivvshutdown Model: El Psi <br /> El fail safe Scrial 4: minutes <br /> El NA <br /> sensor Secoudary containment repairs for: <br /> ❑ El positive shutdown Model: El UDC(s) piping <br /> El fail safe Serial ft: Sump(s) IJST(.$) <br /> El NA <br /> LJ Drop tube with mechanical overfill at 951Xu El Cold start o I'moni toring panel <br /> El Drop tube with mechanical ovcrfill. at 95% El Corrosion protection <br /> El Overfill prevention (see LG letter 150-1) Ej Ot cr. see below <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> LRD ln.speclLir, Recclvcd Ry: <br /> EHD 23.04 <br /> Rev 06/22/07 <br />