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01-11-'13 11.55 FROM-West Star Envmt Inc. +559-277-0106 T-880 P0005/0005 F-417 <br /> ecna. reea°eea <br /> LtElv Efate: January 77,2013 <br /> Requested By: Vlotorla Bowden <br /> EN%EN T C. Telephone: (559)277-937$x3005 <br /> SALES -CWRUCRON -sEavtCE Fax: r5-59T27--0706 <br /> 4770 W.JEMN AI e.,FRESNU, 93722 <br /> (554)277 378/F 59)2 -9106 <br /> Ya:. � <br /> INSPECTION REQUEST <br /> Facility Details <br /> APCD Permit# <br /> Facility Name: ESCALON MINI MART Contact Name: BILL <br /> Facility Address: 1097 E.YOSEMITE Telephone: (209)830-15146 <br /> City/State/Zip ESCALON,CA 95320 Fax: (209)838- 1546 <br /> Schedule Type: <br /> Facility Start-up X Routine Compliance Canceiiation RescheduleRetest <br /> I ControlDRUM v'ron ens e s <br /> AREAMPECTOR Attention: <br /> Phone Number:_ (2-0J468-3420 <br /> Fax Number: (209)464.3433 <br /> Test Time: Test Time: 01/14/2013 2:00 F M. <br /> TP201.18-Static Torque Annual Monitoring&Spill Bucket <br /> TP201.1 C/O-Drop Tube Spill Bucket Only <br /> T13201.1 E-Leak Rate&Pressure SB989 Test ' <br /> TP 201.3 Leak Decay(ST30) SB989 Repair&Retest <br /> c TP 201.38 Leak decay(ST38) Mechanical Leak Detector Test <br /> TP201.4 Back Pressure(ST27) Pressure Line Test <br /> IJ TP201.5 Air to Liquid Ratio(A/L) Cathodic Protector <br /> TP201.60 Liquid Removal Integrity Tightness <br /> V/L(Vapor over Liquid) Designated Operator Inspection <br /> X X HIRT VCS 100 Operability Primary Piping Inspection <br /> HIRT-Pressure Test(G-70-139) Secondary Piping Inspection <br /> Healy Liquid Condensation Trap Temporary UST Closure Inspectic <br /> VR201 (Clean Air Separator) Helium Test <br /> Healy Fil!neck Vapor Pressure Miscellaneous <br /> Regulation(G-70-187) <br /> Healy Vapor Return Line Vaccum <br /> Integrity(G-70-187) <br /> ISD Operability 3 TEST <br /> Healy Dispenser Integrity <br /> Inspector acknow edgement: spec ar ac now a gemen <br /> Confirmation#: Confirmation#: <br /> Comments: <br /> Customer Acknowledgement E30n Account Trav/Mi <br /> APCD Acknowledgement COQ Permit <br /> EHD Acknowledgement Contract Rates °°°'®°°" Fee to Obtair <br />