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UNDK A <br />Facility N. e: <br />LFiclll ess: <br />UT <br />n <br />C <br />LIN <br />LE <br />SAN JOAQUIN COUNTY <br />IRVIRONMENTALHEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 9 DEPARTMENT <br />029 <br />Telephone: (209) 468-3420 Far: (209) 468-3433 Web: www.sieov orp <br />(RAGE TANK (INTI vDnnn . w. --._ _ <br />SERVICE <br />_ <br />Leak detector <br />❑ n <br />chanical Model: <br />❑ 6 <br />Aronic Serial #: <br />C <br />line test programmed <br />_ <br />Leak detector <br />❑ m <br />;hanical Model: <br />❑ el <br />:tronic Serial #:- <br />E <br />ine test programmed <br />_ <br />Leak detector <br />❑ in <br />hanical Model: <br />❑ eli <br />tronic Serial # <br />❑ <br />ine test programmed <br />sensor <br />❑ po <br />tive shutdown Model: <br />❑ fai <br />;afe Serial # <br />❑ NJ <br />LOsensor <br />ive shutdown Model: <br />afe Serial <br />LposO_ sensor <br />ive shutdown Model: <br />afe Serial <br />0 <br />9Z'15SS--- UZ <br />P tube with mechanical overfill at 95% <br />'top tube with mechanical overfill at 95% <br />Overfi prevention (see LG letter 150-1) <br />RVLL7 <br />-7 C TV, <br />SERVICE <br />Spill bucket <br />❑ ❑ 1 hour hydrostatic <br />❑ Caldwell System <br />Spill bucket <br />❑ ❑ 1 hour hydrostatic <br />❑ Caldwell System <br />Spill bucket <br />❑ ❑ 1 hour hydrostatic <br />❑ Caldwell System <br />❑ minimum 5 gallon <br />❑ Incon TS -STS <br />❑ Other <br />❑ minimum 5 gallon <br />❑ Incon TS -STS <br />❑ Other <br />❑ minimum 5 gallon <br />❑ Incon TS -STS <br />❑ Other <br />I Primary piping testing at: <br />❑ psi <br />minutes <br />Secondary piping testing at: <br />❑ psi <br />minutes <br />Secondary containment repairs for: <br />❑ UDC(s) Piping <br />Sump(s) UST(s) <br />❑ Cold start of monitoring panel <br />❑ Corrosion protection <br />Other: see below <br />-HD 23-04 <br />2ev 06/22/07 <br />