COMPLIANCE INFO_2007-2015 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTME 600 East Main Street, Stockton, CA 95202-3029 Telephone: (209) 468-3420 Fax. (209) 468-3433 Web: www.siRov.org/ehd UN1)LKUKUUfNV a1UKAUL IAIN K (UJ1) YKUIiKAIVI NEKVIUL K.LquhNI 11NSrEU1IUlN FmrUK1 Facilityame:. Inspection Date: �7 • Zo • o -7 Facility Address: Service Request #: 2;0k* S. ""OeAl(tej s-1 K-tDraGq QS2DCo GIL 06SD934- Onsite Service Technician's Name: ICC Se ' Tec hnician/Installer Certification #: Manufacturer Training: 4 4' ®� li I►1i. � SERVICE 10 t Leak detector ❑ Rmechanical Model: ❑ electronic Serial #: ❑ line test programmed ❑ Leak detector ❑ ❑ mechanical Model: Title: " ❑ electronic Serial #: ❑ ❑ line test programmed Leak detector ❑ ❑ mechanical Model: ❑ ❑ electronic Serial #: ❑ line test programmed sensor ❑ ❑ positive shutdown Model: ❑ fail safe Serial #: ❑ NA ❑ sensor ❑ ❑ positive shutdown Model: ❑ fail safe Serial #: ❑ ❑ NA ❑ sensor ❑ ❑ positive shutdown Model: ❑ fail safe Serial #: ❑ NA ❑ Drop tube with mechanical overfill at 95% ❑ Drop tube with mechanical overfill at 95% ❑ Overfill prevention (see LG letter 150-1) SERVICE 10 t Spill bucket ❑ minimum 5 gallon ❑ ❑ 1 hour hydrostatic ❑ Incon TS -STS ❑ Caldwell System ❑ Other Spill bucket ❑ minimum 5 gallon ❑ ❑ 1 hour hydrostatic ❑ Incon TS -STS tori ❑ Caldwell System ❑ Other Title: " Spill bucket ❑ minimum 5 gallon ❑ ❑ 1 hour hydrostatic ❑ Incon TS -STS ❑ Caldwell System ❑ Other Primary piping testing at: ❑ psi minutes Secondary piping testing at: ❑ psi minutes Secondary containment repairs for: ❑ UDC(s) Piping Sump(s) UST(s) Cold start of monitoring panel V� ❑ Corrosion protection ❑ Other: see below EHD 23-04 Rev 06/22/07 Gj q-- �.i 10 t Dci �tMlc il-- I S. t�ia✓) . � � N. ,c✓ THIS FA61LITY IS SUBJECT TO REIN TION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. s tori Received y: Title: " EHD 23-04 Rev 06/22/07 Gj q-- �.i