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o�cl llY�� <br />/?•' �_ �� SAN JOAQUIN COUNTY is <br />2 �r ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.slQov.orq/ehd <br />9 17, <br />7"-- <br />� <br />- 1-`f3R <br />UNDERGROUND STORAGE TANK (UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br />Facility Name: <br />Inspection Date: <br />Flag City Chevron <br />Friday, February 22, 2013 <br />Facility Address: <br />Service Request #: <br />6421 Capitol Ave., Lodi <br />SR0066648 <br />Onsite Service Technician's Name: <br />ICC Service Technician/Installer Exp. Date: <br />Manufacturer Training: {� <br />Ronnie Lewis/Pat Mulhall <br />RL 8/16/13 / PM 4/17/14 <br />VR 6/19/13 VMIT13615 VMI .Asif-. <br />SERVICE <br />Leak detector <br />Fxl <br />N mechanical Model:'_(' Petro STP -MLD (blue) <br />❑ electronic Serial #: <br />❑ line test programmed <br />Leak detector <br />❑ <br />❑ mechanical Model: <br />❑ electronic Serial #: <br />❑ <br />❑ line test programmed <br />Dsl Annular sensor <br />0 <br />❑ positive shutdown Model: <br />❑ fail safe Serial #: <br />❑ NA <br />❑ <br />sensor <br />❑ positive shutdown Model: <br />❑ fail safe Serial #: <br />❑ <br />❑ NA <br />❑ <br />sensor <br />❑ <br />❑ 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 />❑X This UST facility is APPROVED to operate <br />SERVICE <br />87 Master Spill bucket ❑ minimum 5 gallon <br />0 1 hour hydrostatic ❑ Incon TS -STS <br />❑ Caldwell System ❑ Other <br />Spill bucket ❑ minimum 5 gallon <br />Z 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) Piping <br />Sump(s) UST(s) <br />❑ <br />Testing for the above components are next due by: <br />Note: Please be aware that 2° 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 />❑ This UST facility is NOT APPROVED to operate <br />Witnessed hydrostatic testing of the 91 spill container - failed. The water could be heard dripping into <br />the fill sump. Witnessed one hour hydrostatic testing of the 87 master spill container - passed. <br />Witnessed testing of the 87 master MLLD at 3 gph at 10 psi - passed. Witnessed functionality <br />verification testing of diesel annular sensor and 87 siphon annular sensor, including sensor out - both <br />passed. The wiring on the 87 siphon annular sensor had come loose and was repaired on site. [Spill <br />container testing done by P.M. MLLD and annular sensor testing done by R.L.] <br />87 master inventory is 734 gallons. 87 siphon inventory is 761 gallons. Red Tag Significant Violation <br />has been corrected. Red Tag has been removed from the two UST fill piping. <br />Still needed: 91 spill container repair/replacement and retest under permit & inspection by EHD. <br />THIS FACILITYA SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD Inspector: Received By: Title: <br />/-- 42— 1 <br />&rte S:,' �psNiE 2 <br />EHD 23-04 Rev. 119/12 fL-�i UST SERVICE REQUEST INSPECTION REPORT <br />