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OCy-20-2008 03 :03 PM GETTLER—RYAN INC. 925 551 4770 P. 02 <br /> AOLt <br /> 1p <br /> SAN JOAQUIN COUNTY <br /> r-NIVIRONWNTAL HEALTH DEPARTW'NT <br /> 600 t:ast Main Street,Stockton,CA 95202-3029 <br /> Telephone:(209)468-3420 F&V.-(209)468-3433 Web:my_%sjg2_v jr&.!eLd <br /> UNDERGROUND STORAGE TANK UST PROGRAM SER REUEST INSPECTION REPORTFecl5lty Name: inspection bat®; <br /> FacSUty Address; Service Request Mt .� <br /> 66 s! Service Teshrdeian's Name; ICC Service TechniciaNlflstaller Certification 4: Manuteeturer T'ralniap: <br /> SERVICE SERVICE <br /> _ <br /> Leak detector <br /> C mechanical Model; ___:spill bucket ❑minimum 5 gallon <br /> 0 electronic Serial #:-�� ----� ❑ ❑ 1 hour hydrostatic 13 Ineon TS-S"I'S <br /> ❑ line test progattimed — � — ❑ Caldwell System ❑ Other <br /> _ _Leak detector <br /> © mechanical Model: ---Spill bucket Elminimum 5 gallon <br /> ® <br /> 11 electronic Serial #:� © C3 1 hour hydrostatic ❑ Incon'r5-STS <br /> ❑ line test Rrog=ed f— ❑ Caldwell System C Other <br /> _ Leak detector _ Spill bucket ❑ minirnuirt S gallon <br /> © El mechanical Model: ...._,,, ❑ El hour hydrostatic 0lncon TS-STS <br /> ❑ electronic Serial #: -_—_-�—�_ � ..- . <br /> ❑ line test programmed ❑ Caldwell System 11 Other <br /> _ <br /> sir Primary piping testing at: <br /> C ® positive shutdown Model: -- _-_ psi <br /> C fail safe Serial #: � minutes <br /> C NA _ <br /> _ sensor Secondary piping testing at: <br /> ❑ ❑ positive shutdown Model: __M,q_�_._.._.______. ❑ <br /> C fail safe Serial #: psi <br /> [INA minutes <br /> sensor Secondary containment repairs for: <br /> ❑ Cl positive shutdown Model: _ ❑ UDC(s) Piping <br /> 13 fail safe Serial #: ._...___.�_..__ _ -- , .�.'.�'".,�.�' <br /> C NA Sump(s)p(s) LIST(s)T(s) <br /> _._____— _ <br /> ❑ Drop tube with mechanical overfill at 95% CD Cold start of monitoring panel <br /> ❑ Drop tube with mechanical overfill at 95% 0 Corrosion protection <br /> ❑ Overfill prevention(see LG letter 150-1) 0 Other: see below ,p <br /> 4 <br /> T a <br /> THIS FACILITY 15 SUBJECT TO REINSPECTION AT ANY TIME AT EHOIS CURR* NT HOURLY RATE: <br /> _]'fHU Snsi+�utur; Recniy�5 icy: r'itle: .. <br /> tlHP�2:5-04 <br />