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0 9 <br /> w4t!!!!Y <br /> xQ Wit'•. SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 'A600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sm ov.org/ehd <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br /> Facility Name: Inspection Date: <br /> Waterloo Food & Fuel Friday, July 9, 2010 <br /> Facility Address: Service Request : <br /> 3030 E. Waterloo, Stockton, CA 95205 SR0060381 <br /> Onsite Service Technician's Name: ICC Service Technician/Installer Exp.Date: Manufacturer Training: <br /> Guadalupe Sanchez 525045-UI 1/15/2010 OPW (1/14/2011) <br /> SERVICE SERVICE <br /> Leak detector 91 <br /> ❑ mechanical Model: Spill bucket 13 minimum 5 gallon <br /> ❑ ❑ electronic Serial#: © ❑1 hour hydrostatic 13Incon TS-STS <br /> ❑Caldwell System ®Other <br /> ❑ line test programmed <br /> Leak detector Spill bucket ❑minimum 5 gallon <br /> ❑ ❑mechanical Model: ❑ C-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 /> ❑mechanical Model: <br /> ❑ ❑electronic Serial#: ❑ ❑ 1 hour hydrostatic ❑Incon TS-STS <br /> ❑line test ro rammed ❑Caldwell System ❑Other <br /> sensor Primary piping testing at: <br /> ❑positive shutdown Model: <br /> ❑ ❑fail safe Serial#: Clmi <br /> ❑NA minutes <br /> sensor Secondary containment testing for: <br /> ❑ ❑positive shutdown Model: UDC(s) Piping <br /> 13 fail safe Serial#: Sump(s) UST(s) <br /> ❑NA <br /> sensor ❑ Testing for the above components are next due by: <br /> ❑ ❑positive shutdown Model: <br /> ❑fail safe Serial#: Note: Please be aware that 21 containment components are required to be tested upon <br /> ❑NA installation,6 months after,and every 36 months thereafter. <br /> ❑ Drop tube with mechanical overfill at 95% ❑ Cold start of monitoring panel <br /> ❑ Drop tube with mechanical overfill at 95% ❑ Corrosion protection <br /> ❑ Overfill prevention(see LG letter 150-1) ❑ Other: see below <br /> Observed corrosion protection provided for riser to newly installed 91 tank OPW-2100 spill bucket <br /> before backfilling. Guadalupe was not on site during this corrosion protection verification inspection, <br /> but he was the one installing the spill bucket according to Robert Barnhart of Reliable Petroleum. <br /> Also verified the spill bucket is capable of holding minimum 5 gallons of liquid during this inspection. <br /> Please be aware the newly installed spill bucket must pass a 1-hour hydrostatic test after backfilling <br /> before deposition of fuel into the 91 tank can restart. <br /> THIS FACILITY IS SUBJECT TO REINS* CTIOOLAT ANY TIME AT EHD' CURRENT HOURLY RATE. <br /> EHD I R 'cj <br /> T •01A <br /> EHD 2304 UST SERVICE REQUEST INSPECTION REPORT <br /> Rev 06/01/10 <br />