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ot'4� i �•• c <br />�.E�' •per SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.orq/ehd <br />UNDERGROUND STORAGE TANK (UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br />Facility Name: <br />Inspection Date: <br />Waterloo Food & Fuel <br />Friday, July 9, 2010 <br />Facility Address: <br />Service Request #: <br />3030 E. Waterloo, Stockton, CA 95205 <br />SR0060381 <br />Onsite Service Technician's Name: <br />ICC Service Technician/installer Exp. Date: <br />Manufacturer Training: <br />Guadalupe Sanchez <br />525045 -UI 1/15/2010 <br />OPW (1/14/2011) <br />SERVICE <br />Leak detector <br />❑ <br />❑ mechanical Model: <br />❑ electronic Serial #: <br />❑ line test programmed <br />❑ <br />Leak detector <br />❑ <br />❑ mechanical Model: <br />❑ electronic Serial #: <br />❑ <br />❑ line test programmed <br />Leak detector <br />❑ <br />❑ mechanical Model: <br />❑ <br />❑ electronic Serial #: <br />❑ line test programmed <br />sensor <br />❑ <br />❑ positive shutdown Model: <br />❑ fail safe Serial #: <br />❑ <br />❑ NA <br />sensor <br />❑ <br />❑ positive shutdown Model: <br />❑ <br />❑ fail safe Serial #: <br />❑ <br />❑ NA <br />sensor <br />El❑ <br />positive shutdown Model: <br />❑ fail safe Serial #: <br />❑ NA <br />❑ <br />Drop tube with mechanical overfill at 95% <br />❑ <br />Drop tube with mechanical overfill at 95% <br />❑ <br />Overfill prevention (see LG letter 150-1) <br />SERVICE <br />91 Spill bucket ❑ minimum 5 gallon <br />❑ 1 hour hydrostatic ❑ Incon TS -STS <br />❑ Caldwell System 0 Other <br />Spill bucket ❑ minimum 5 gallon <br />❑ <br />❑ 1 hour hydrostatic ❑ Incon TS -STS <br />❑ Caldwell System ❑ Other <br />Spill bucket ❑ minimum 5 gallon <br />❑ <br />❑ 1 hour hydrostatic ❑ Incon TS -STS <br />❑ Caldwell System ❑ Other <br />Primary piping testing at: <br />❑ <br />psi <br />minutes <br />Secondary containment testing for: <br />UDC(s) Piping <br />Sump(s) UST(s) <br />❑ <br />Testing for the above components are next due by: <br />Note: Please be aware that 21 containment components are required to be tested upon <br />installation, 6 months after, and every 36 months thereafter. <br />❑ <br />Cold start of monitoring panel <br />❑ <br />Corrosion protection <br />❑ <br />Other: see below <br />Observed corrosion protection provided for riser to newly installed 91 tank OPW -2100 spill bucket <br />before backfilling. Guadalupe was not on site during this corrosion protection verification inspection, <br />but he was the one installing the spill bucket according to Robert Barnhart of Reliable Petroleum. <br />Also verified the spill bucket is capable of holding minimum 5 gallons of liquid during this inspection. <br />Please be aware the newly installed spill bucket must pass a 1 -hour hydrostatic test after backfilling <br />before deposition of fuel into the 91 tank can restart. <br />THIS FACILITY IS SUBJECT TO REINSP,&1001.4AT ANY TIME AT EHD' CURRENT HOURLY RATE. <br />LEHD Insp:7 <br />(q % R Ti <br />EHD 2304 UST SERVICE REQUEST INSPECTION REPORT <br />Rev 06/01/10 <br />