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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 /> ••�<<F OR��7 <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br /> Facility Name: Inspection Date: <br /> Waterloo Liquors Monday, October 18, 2010 <br /> Facility Address: Service Request#t: <br /> 2512 E. Waterloo Rd., Stockton SR0061062 <br /> Onsite Service Technician's Name: ICC Service Technician/installer Exp.Date: Manufacturer Training: <br /> Steve Zwahlen 18025473UI 4/30/2012 Frankln 4443693761 10/29/2010 <br /> SERVICE SERVICE <br /> Leak detector <br /> ❑ mechanical Model: _Spill bucket ❑minimum 5 gallon <br /> ❑ ❑ electronic Serial#: ❑ ❑1 hour hydrostatic ❑Incon TS-STS <br /> ❑ line test programmed <br /> ❑Caldwell System ❑Other <br /> Leak detector Spill bucket ❑minimum 5 gallon <br /> ❑ ❑mechanical Model: ❑ ET—1hour 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: <br /> ❑ <br /> 13 electronic Serial#: ❑ ❑1 hour hydrostatic 13 Incon TS-STS <br /> ❑line test ammed ❑Caldwell System ❑Other <br /> sensor Primary piping testing at: <br /> ❑positive shutdown Model: <br /> ❑ <br /> 13 fail safe Serial#: ❑ minutes <br /> ❑NA <br /> sensor Secondary containment testing for: <br /> ❑ ❑positive shutdown Model: UDC(s) 87 Piping <br /> 13 fail safe Serial#: Sump(s) UST(s) <br /> ❑NA <br /> sensor Testing for the above components are next due by: <br /> positive sitive shutdown Model <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 LG letter 150-1) ❑ Other: see below <br /> -- Observed secondary containment test of the 87-octane fuel piping at 5 psi maintained for one hour <br /> post pouring of concrete on 10/13/2010. Passed. Permit condition of SR0061062 has been met. <br /> -- 87 and 91-octane UST product inventory levels were 1,872.73 and 1,064.42 gallons, respectively. <br /> Red Tag Significant Violation has been corrected; Red Tag has been removed from the two UST fill <br /> piping. UST System has returned to compliance and may resume operation. <br /> -- Observed Incon TS550 monitoring panel with incorrect time. CCR 2638 requires proper calibration <br /> of monitoring equipment to be tested and certified annually. Corrected on site by technician. <br /> THIS,FACAITY IS 4UMCT TO REINSPECTION T NY T1W A HD'S CURRENT HOURLY RATE. <br /> EHD Received B Tide: <br /> EHD 23-04 UST SERVICE REQUEST INSPECTION REPORT <br /> Rev 06/01/10 <br />