Laserfiche WebLink
SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENP <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax.- (209) 468-3433 Web: www.sj2py.orchd <br />UNDERGROUND STORAGE TANK LUST) PROGRAM SERVICE UEST INSPECTION REPORT <br />Facility Name: Inspection Qate: <br />Pr1% I 'I i. <br />le- 4 — 1- f V5 <br />G*0�n W -) & I <br />Facility Address: I Service Request #: <br />1 0 Oi;site Service Technician's Name: <br />ALK Fzii <br />1011.W.JMlwf� <br />IC n/Installer Certification #: <br />-53c;78Y'W <br />Manufacturer Training: <br />— ki—P, I o .k. I ZJ3 )e--711 <br />SERVICE <br />Leak detector <br />■ <br />■ mechanical Model: <br />0 electronic Serial #: <br />El <br />El line test programmed__ <br />Leak detector <br />1 <br />r-1••- <br />-1 mechanical Ml: <br />0 <br />electronic <br />D <br />El line test programmed <br />Leak detecto■ r <br />❑ <br />0 mechanical Model: <br />0 electronic Serial #: <br />0 line test programmed <br />sensor <br />0 positive shutdown Model: <br />El fail safe Serial #: <br />F-1 <br />0 NA <br />sensor <br />■ <br />0 positive shutdown Model: <br />0 <br />El fail safe Serial #: <br />0 <br />DNA <br />Not <br />■ <br />■ <br />Drop tube with mechanical overfill at 95% <br />Drop tube with mechanical overfill at 95% <br />Overfill prevention (see LG letter 150- 1) <br />Manufacturer Training: <br />— ki—P, I o .k. I ZJ3 )e--711 <br />SERVICE <br />Spill bucket 0 minimum 5 gallon <br />El El I hour hydrostatic El Incon TS -STS <br />El Caldwell System El Other <br />Spill bucket 0 minimum 5 gallon <br />El <br />0 1 hour hydrostatic 1:1 Incon TS -STS <br />0 Caldwell System El Other <br />- Spill bucket El minimum 5 gallon <br />0 <br />0 1 hour hydrostatic 0 Incon TS -STS <br />0 Caldwell System F-1 Other <br />Primary piping testing at: <br />❑ <br />psi <br />minutes <br />Secondary piping testing at: <br />psi <br />minutes <br />Secondary containment repairs for: <br />F-1 <br />UDC(s) Piping <br />Sump(s) UST(s) <br />Cold start of monitoring panel A I., <br />0 <br />Corrosion protection <br />0 <br />Other: see below <br />WOW= <br />EHD 23-04 <br />Rev 06/22/07 <br />J!AM <br />A <br />WIN' <br />EHD Inspector: <br />oo <br />EHD 23-04 <br />Rev 06/22/07 <br />