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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.org/ehd <br />UNDERGROUND STORAGE TANK (UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br />Facility Name: <br />Inspection Date: <br />Quik Stop Markets #39 <br />Wednesday, July 14, 2010 <br />Facility Address: <br />Service Request: <br />2285 E. Fremont, Stockton <br />SR0060429 <br />Onsite Service Technician's Name: <br />ICC Service Technician/Installer Exp. Date: <br />Manufacturer Training: <br />Joe Bartholdi (Elite IV) <br />Joe Bartholdi (7/7/2012) <br />VR Lv12/3 B36852 (01/2011) <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 />E] <br />❑ line test programmed <br />Leak detector <br />❑ <br />❑ mechanical Model: <br />❑ <br />❑electronic Serial #: <br />❑ line test programmed <br />87 PIPING sensor <br />❑x <br />0 positive shutdown Model: <br />Elfail safe Serial #: <br />❑ <br />❑ NA <br />91 PIPING sensor <br />❑ <br />M positive shutdown Model: <br />❑ <br />©fail safe Serial #: <br />❑ <br />❑ NA <br />87/91annu sensor <br />❑ positive shutdown Model: <br />17 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 />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 />Spill bucket ❑ minimum 5 gallon <br />E] <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 />Relays for the existing 87 and 91 STP liquid sensors were switched so the 91 STP was shutoff when <br />the 87 sensor was tested, and vice versa. Technician changed the relays and the correct positive <br />shutoff was verified when tested again on site. Observed audible and visual alarm testing of the <br />above four liquid sensors; passed. Observed sensor out and fail safe; passed. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD <br />EHD 2304 <br />Rev 06/01110 <br />)RT <br />