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at'g� I�'• � <br />SAN JOAQUIN COUNTY <br />XENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />'rcik' <br />Z ' 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 />Monday, October 11, 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 />15259508UT 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 />O 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 />D positive shutdown Model: <br />O fail safe Serial #: <br />® <br />❑ NA <br />sensor <br />❑ <br />❑ positive shutdown Model: <br />❑ <br />O fail safe Serial #: <br />❑ <br />❑ NA <br />sensor <br />❑ <br />13 positive shutdown Model: <br />❑ 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 O minimum 5 gallon <br />❑ <br />❑ 1 hour hydrostatic ❑ Incon TS -STS <br />O Caldwell System ❑ Other <br />Spill bucket O minimum 5 gallon <br />❑ <br />❑ 1 hour hydrostatic ❑ Incon TS -STS <br />❑ Caldwell System ❑ Other <br />Spill bucket ❑ minimum 5 gallon <br />❑ <br />O 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) 87, 91,diesel Piping <br />Sump(s) UST(s) <br />® <br />Testing for the above components are next due by: <br />Note: Please be aware that 20 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 />Observed secondary containment testing of the diesel, 91 -octane fuel piping at 5 psi maintained for <br />one hour. Passed. I <br />Confirmed visual fail of the secondary containment test of 87 -octane fuel piping. Observed soap <br />bubbles and hissing sound at the 87 -octane boot in UDC #1/2. <br />UST system not ready to return to operation as required under SR0057217 permit conditions. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT AT 'S CURRENT HOURLY RATE. <br />EHD Received By: Title: <br />EHD 23.04/ / UST SERVICE REQUEST INSPECTION REPORT <br />Rev 06/01/10 v <br />