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02/62/21312 14:50 209-5908 CSI 1714 � PAGE 06/06 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />6013 East Main Street, StWkt0n, CA 35202-3029 <br />Ta# horae <br />(209) 468-3420 Fair. (209) 463-3433 Web: www.siggy.orat h <br />UNDERGROUND STORAGE TANK (UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br />F��Ity t�lanra: <br />Chevron <br />Facility I ddr rs: <br />1442 Colony Road, Ripon <br />Onsft SOM00 T"hnicium's k I= Service Trye4chnkk <br />Joey Mesa iCC9 5-2594 8 <br />SERVICE <br />Leak detector <br />11 mechanical mom: <br />11 electronic Serial #' <br />[J line test pmrammed <br />Spill bucket Q minimum 5 gallon <br />Q <br />Leak detector <br />❑ Caldwell System El Mer <br />D mechanical Model_ <br />SPIN bucket 0 minimum 5 gallon <br />® elecfronic Serial #' <br />-hour hydrostatic 0 Incon TS -STS <br />r3 line test pnranInled <br />13 Caldwell System 0 Other <br />sensor <br />E] <br />13 eve shutdown Model: <br />psi <br />Q fail safe Serial. <br />mim tes <br />13 NA <br />Secondary Containment testing for: <br />58ri5or <br />Lj <br />® positive shutdown Model: <br />Sump(s) UST(s) <br />11 fail safe Serial M <br />Tesfing 1()t the above componetds are ne)d due by: <br />0 NA <br />rso ap 0-21,—**-nr*--;—m Wo to b. isame L" <br />in—Waft 4 mam.r aw. e'W every 85 4w he fir. <br />sensor <br />Q <br />(3 positive shutdown Model, <br />Corrosion protection <br />❑ fail safe Se" 47 <br />i7ther see below <br />Ci NA <br />Drop tube vitt mechaNca oveMll at 95% <br />E <br />Drop tube with rnechani cal overfill at 95% <br />C <br />Overfill prevention (,-,ee LG letter 150-1) <br />R This UST facility Is APPROVED to opomte <br />i it48p8�tiotE Date; <br />Thirsday, Febf-uary �, 2612 <br />SGrAca i quast 1E <br />SRO064231 <br />�lirtaswler EV, mate: Uanuixcturer Toainiito: <br />5113 VR A277961113112 <br />SERVICE <br />Spill bucket Q minimum 5 gallon <br />Q <br />0 1 hour hydrostatic 173 Incon Ts -STS <br />❑ Caldwell System El Mer <br />SPIN bucket 0 minimum 5 gallon <br />❑ <br />-hour hydrostatic 0 Incon TS -STS <br />13 Caldwell System 0 Other <br />Printery piping testing at: <br />psi <br />mim tes <br />Secondary Containment testing for: <br />UDC(8) Piping <br />Sump(s) UST(s) <br />Tesfing 1()t the above componetds are ne)d due by: <br />rso ap 0-21,—**-nr*--;—m Wo to b. isame L" <br />in—Waft 4 mam.r aw. e'W every 85 4w he fir. <br />Cold start of morifto4ng panel <br />® <br />Corrosion protection <br />❑ <br />i7ther see below <br />❑ Thl!, UST facility is € OT APPROVE[) to operate <br />Service Station Systems authorized Tanknology to perform, the cold start (112352) during the <br />monitoring certifiaahor performed today. <br />All sensors Passed, verified positive shut down and fail safe, also verified overfill @ 90% and PL.LD. <br />All passed. <br />ilii s FACILITY la Su5jEGT To REINSPECTION AT ANY TIME AT EHO'S CURRENT 14OURLY @ Tf--,. <br />LflDIruSecio€; R ivod By; Me: <br />All ' lbow v <br />R 2304 <br />Rev 1 WWI 0 UST SEWAGE REE QUEST INSPEZMN REP04RT <br />