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Oct. 30. 2006 11 :42AM Wept Star Environmental, Inc. No. 0729 P. 1/1 <br /> Ak <br /> HILL E ���� Date' October 3,2006 <br /> "STAR Requested By-,Monica Arredondo <br /> e.�l WMIINTALJINC. Telephone: 559-277-9378 x3010 <br /> SALES'c1lirmucIrlord-SERVICE Fax; 559-277-0106 <br /> 4608 W.Ser ere 101.Fmm6M Ca.93722 <br /> (559) 79/ 669)277-0106 <br /> INSPECTION REQUEST <br /> APCD Permit <br /> Facility Details <br /> # _ <br /> Fatality Name: Ef4aton Mini Mart Contact Name: _Bill <br /> F80ft Address: 1097 E.Yosemite Telephone: 209-838-1546 <br /> City/StateOp Escalon CA 95320 Fax: 209-838-1546 <br /> Schedule Type: <br /> Facility Start-up X Routine Compliance �,,,.... Cancellation ' i ReSCh�dule 6....1 Retest <br /> Air Polution Control Dist. Environmental Health Dept. <br /> ACCetltion: Attention: Toua Yang <br /> Phone Number. ! Phone Number: 209 468-3459 <br /> Fax Number: Fax Number: 209 468.3433 t <br /> : E <br /> : m <br /> Test Time: ? i Test Time: Monday,November 08,2006 <br /> ❑ TP201.1 B-Static Torque ! ® Annual Monitoring <br /> TP201.1C/D-Drop Tubo ® Spill Buckets Only <br /> ® TP 201.3 Leak decay(ST30) ® S8989 <br /> ❑ TP 201.36 Leak Decay(ST3$) ❑ Mechanical Leak Detector Test <br /> ® TP201.3C Pipe Connections Test ® Pressure Line Test <br /> TP201.4 Back Pressure(ST27) ❑ Cattmtic Protector <br /> E ❑ TP201.5 Air to Liquid Ratio j Integrity Tightness <br /> m - <br /> © TP201.6C Liquid Removal ': ❑ Designated Operator Inspection <br /> LJ VR101B ❑ Primary Piping Inspection <br /> ® Secondary Piping Inspection <br /> ❑ Temporary UST Inspection <br /> i Inspector acknowledgement: Inspector acknowledgement <br /> Cotlrirmation#: Confirmation#;Verbal Per Toua Y <br /> anqi <br /> Comments: Please write the Facility lD#S and Confirmation tt can your iesultsl <br /> Tester Information <br /> ❑Customer Acknowledgement [70n Account Trav/Mi <br /> ❑APCDAcknowledgement ❑COD Permit <br /> F]EHD Acknowledgement [7]Contract Rates _ - Fee to Obain <br /> 61 <br /> uw� M 1 q <br /> d <br /> r <br />