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��� A4tJlN <br />a. X <br />�q�IFORa`P <br />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.sjgov.org/ehd <br />UNDERGROUND STORAGE TANK (UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br />Facility Name: <br />Inspection Date: <br />Waterloo Liquor <br />Tuesday, July 27, 2010 <br />Facility Address: <br />Service Request: <br />2512 E. Waterloo <br />SR0057217 <br />Onsite Service Technician's Name: <br />ICC Service Technician/Installer Exp. Date: <br />Manufacturer Training: <br />Jesse Vera <br />5259508UT 5/5/2012 <br />Franklin 357353761 11/25/10 <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 />❑ NA <br />sensor <br />❑ <br />❑ positive shutdown Model: <br />❑ <br />❑fail safe Serial #: <br />x❑ <br />❑ NA <br />sensor <br />❑ <br />❑ positive shutdown Model: <br />13 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 />❑ <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) fuel Piping <br />Sump(s) 91 octane UST(s) <br />Testing for the above components are next due by: <br />Note: Please be aware that 2° 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 />x❑ <br />Other: see below <br />Observed secondary containment testing for fuel piping and the 91 octane UST. 91 octane UST <br />passed secondary containment test at a vacuum pressure of -10 p.s.i. Fuel piping failed the <br />secondary containment test as it was unable to maintain pressure due to a torn boot in the UDC for <br />the 91 octane tank. Submit a permit application to EHD to repair the secondary containment of the <br />fuel piping by a certified contractor by August 27, 2010. <br />Observed 1 -hr hydrostatic test for the 91 octane STP sump using the Incon TS -STS System. Passed. <br />THIS CILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD I ped Received B Title: <br />EHD 2 J \"•lJ, UST SERVICE REQUEST INSPECTION REPORT <br />Rev O6/01/10 <br />