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x� � • SAN JOAQUIN COUNTY • <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www siaov.orD/ehd <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br /> Facility Name: Inspection Date: <br /> Shell Oil Products US - Stockton Terminal Friday, October 24, 2014 <br /> Facility Address: Service Request#: <br /> 3515 Navy Dr., Stockton SR0070805 <br /> Onsite Service Technician's Name: ICC Service Technician/Installer I Date: Manufacturer Training: <br /> Victor Guerrero 6/11/15 Ronan X76 7/26/15 <br /> SERVICE SERVICE <br /> Leak detector Spill bucket ❑ minimum 5 gallon <br /> ❑ ❑mechanical Model: ❑ ❑ 1 hour hydrostatic ❑ Incon TS-STS <br /> ❑electronic Serial#: ❑ Caldwell System ❑ Other <br /> ❑ line test programmed <br /> Leak detector Spill bucket ❑ minimum 5 gallon <br /> Ei ❑ mechanical Model: ❑ ❑ 1 hour hydrostatic ❑ Incon TS-STS <br /> ❑ electronic Serial#: ❑ Caldwell System ❑ Other <br /> ❑ line test programmed <br /> Overfill sensor Primary piping testing at: <br /> ❑x ❑positive shutdown Model: Ronan 1-S-3 ❑ _psi <br /> ❑fail safe Serial#: _minutes <br /> ❑ NA <br /> sensor Secondary containment testing for: <br /> ❑ ❑ positive shutdown Model: UDC(s) Piping <br /> ❑fall safe Serial#: Sump(s) UST(S) <br /> ❑ NA ❑ <br /> sensor Testing for the above components are next due by: <br /> El [I <br /> positive shutdown Model: <br /> ❑fall Safe Serial#: Note: please be aware mat r pop,,men,components are mooned to ee tested upon <br /> ❑ NA inaudlation,6111 allot,and every 36 monms hameer. <br /> ❑ Drop tube with mechanical overfill at 95% ❑ Cold start of monitoring panel <br /> ❑ Drop tube with mechanical overfill at 95% ❑ Corrosion protection <br /> 11131 <br /> Overfill prevention(see LG letter 150-1) El Other: see below <br /> NX This UST facility is APPROVED to operate ❑ This UST facility is NOT APPROVED to operate <br /> Witnessed functionality verification testing of the waste water tank overfill sensor, including sensor ou' <br /> Passed. <br /> The sensor has been set to alarm at 80% of the tank capacity. The length of the cord at this level is <br /> 96 inches. <br /> THIS FACIL SUBJECT TO REINSPECTI AT A TIME AT EHD'S CURRENT HOURLY RATE. <br /> 1: 11)Ins ctor: Rece By: T /� <br /> l 1/ <br /> �,YG*L <br /> EHD 23 Rev.5 <br /> 2 � 6��� UST SERVICE REQUEST INSPECTION REPORT <br />