Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,CA 95202-3029 <br /> Telephone:(209)468-3420 Fax. (209)468-3433 Web:www.sigov.orgleh <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM SERVICE R QUEST INSPECTION REPORT <br /> Facility Name: Inspection Date: <br /> �ias 76 /11 27 07 <br /> Facility Address: Service Request#: <br /> Aix <br /> -L <br /> Onsite Service Technician's Name: ICC Service Technician/Installer Certification#: Manufacturer Training: <br /> Ep -31 392- 9 - C4 1 3-730 122 6-7 <br /> SERVICE SERVICE <br /> Leak detector Spill bucket 0 minimum 5 gallon <br /> ❑ El mechanical Model: --A/ <br /> F1 electronic Serial W- El I hour hydrostatic 0 Incon TS-STS <br /> pE0 Caldwell System El Other <br /> E] line test roammed <br /> Leak detector —Spill bucket 0 minimum 5 gallon <br /> ❑ 0 mechanical Model: 0 El I hour hydrostatic 0 Incon TS-STS <br /> 0 electronic Serial 0 Caldwell System El Other <br /> El line test programmed <br /> . Leak detector Spill bucket 0 minimum 5 gallon <br /> El 0 mechanical Model: El F-1 I hour hydrostatic 0 Incon TS-STS <br /> R electronic Serial#: El Caldwell System 0 Other <br /> El line test programmed <br /> sensor Primary piping testing at: <br /> El El positive shutdown Model: ❑ psi <br /> 0 fail safe Serial #: <br /> minutes <br /> EINA <br /> sensor Secondary piping testing at: <br /> El El positive shutdown Model: ❑ psi <br /> El fail safe Serial #: minutes <br /> 0 NA <br /> sensor Secondary containment repairs for: <br /> ❑ 0 positive shutdown Model: ❑ UDC(s) Piping <br /> El fail safe Serial Sump(s) UST(s) <br /> El NA <br /> R Drop tube with mechanical overfill at 95% 0 Cold start of monitoring panel <br /> ❑ Drop tube with mechanical overfill at 95% EV Corrosion protection — f5-7 set <br /> 0 Overfill prevention(see LG letter 150-1) 0 Other: see below <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> EHD Inspector: Received By: Title: <br /> EHD 23-04 <br /> o_..AmInnin-Y <br />