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AQU 1 ly <br /> °'• ''O SAN.JOAQUIN COUNTY <br /> tn.` y� ENVIRONMENTAL HEALTH DEPARTMENT <br /> ?. 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sogov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br /> Facility Name: Inspection Date: <br /> Tracy Truck & Auto Stop October 12, 2010 <br /> Facility Address: Service Request#: <br /> 3940 N. Tracy Blvd., Tracy SR0060197 <br /> Onsite Service Technician's Name: ICC Service Technician/Installer Exp.Date: Manufacturer Training: <br /> Lyle Nimmo / Greg Kaiser 6/30/11 / 9/23/11 <br /> SERVICE SERVICE <br /> Leak detector <br /> 11 mechanical Model: Spill bucket ❑minimum 5 gallon <br /> 1711 11 ❑1 hour hydrostatic ❑ Incon TS-STS <br /> 11 electronic Serial#: <br /> 11 line test programmed <br /> ❑Caldwell System ❑Other <br /> Leak detector Spill bucket ❑minimum 5 gallon <br /> ❑ ❑mechanical Model: ❑ ❑1 hour hydrostatic ❑ Incon TS-STS <br /> ❑electronic Serial#: ❑Caldwell System ❑Other <br /> ❑ line test programmed <br /> Leak detector Spill bucket ❑minimum 5 gallon <br /> ❑ ❑mechanical Model: ❑ ❑1 hour hydrostatic ❑ Incon TS-STS <br /> ❑electronic Serial#: ❑Caldwell System ❑Other <br /> ❑line test programmed <br /> sensor Primary piping testing at: <br /> ❑ ❑positive shutdown Model: 0 60 psi <br /> ❑fail safe Serial#: 30 minutes <br /> ❑NA <br /> sensor Secondary containment testing for: <br /> ❑ ❑positive shutdown Model: 17/18 UDC(s) Diesel Piping <br /> ❑fail safe Serial#: Sump(s) UST(s) <br /> ❑NA <br /> sensor Testing for the above components are next due by: <br /> ❑ ❑positive shutdown Model: October 2013 <br /> ❑fail safe Serial#: Note: Please be aware that 2°containment components are required to be tested upon <br /> ❑NA installation,6 months after,and every 36 months thereafter. <br /> ❑ Drop tube with mechanical overfill at 95% ❑ Cold start of monitoring panel <br /> ❑ Drop tube with mechanical overfill at 95% ❑ Corrosion protection <br /> ❑ Overfill prevention(see LIS letter 150-1) ❑ Other: see below <br /> Witnessed secondary containment testing of diesel piping - 1 hour @ 5 psi. Passed. Witnessed <br /> primary piping test of diesel main & satellite piping at dispenser 17/18 - 30 minutes @ 60 psi. <br /> Passed. Witnessed 1 hour hydrostatic testing of UDC 17/18. Passed. OK to operate UST system. <br /> **Note: If primary line testing is determined to not be equivalent to 60 minutes @ 50 psi, testing will <br /> need to be redone. <br /> THIS FACILITY-LS SUBJECT TO REINSPECTIO ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> EHD Ins ctor: � R7V11y. Titl <br /> EHD 23-04 UST SERVICE REQUEST INSPECTION REPORT <br /> Rev 06/01/10 <br />