COMPLIANCE INFO_2013-2018 - Laserfiche WebLink

Home Browse Search

r �gvsh .G I� y� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.si og v_org/ehd 'kd;..... SERVICE Leak detector ❑ ❑ mechanical Model: • ❑ electronic Serial #: THIS FACILITY IS SUBJECT ••' •: RATE. ❑ line test programmed ❑ Leak detector ❑ ❑ mechanical Model: ❑ electronic Serial #: ❑ ❑ line test programmed sensor ❑ ❑ positive shutdown Model: ❑ fail safe Serial #: ❑ NA ETISump(s) sensor ❑ ❑ "positive shutdown Model: ❑ ❑ fail safe Serial #: ❑ ❑ NA ❑ sensor ❑ ❑ positive shutdown Model: ❑ fail safe Serial #: ❑ NA ❑ Drop tube with mechanical overfill at 95% ❑ Drop tube with mechanical overfill at 95% ❑ Overfill prevention (see LG letter 150-1) ❑ This UST facility is APPROVED to operate SERVICE Spill bucket ❑ minimum 5 gallon ❑ ❑ 1 hour hydrostatic ❑ Incon TS -STS • ❑ Caldwell System ❑ Other THIS FACILITY IS SUBJECT ••' •: RATE. Spill bucket ❑ minimum 5 gallon ❑ ❑ 1 hour hydrostatic ❑ Incon TS -STS ❑ Caldwell System ❑ Other Primary piping testing at: ❑ psi minutes Seco Clary containment testing for: UDC(s) Piping UST(s) ETISump(s) Testing for the above components are next due by: Note: Please be aware that 2° containment components are required to be tested upon installation, 6 months after, and every 36 months thereafter. ❑ Cold start of monitoring panel ❑ Corrosion protection ❑ Other: see below ❑ This UST facility is NOT APPROVED to operate ...��. �..� .� .�111E., 11111 11 a `+ a r • THIS FACILITY IS SUBJECT ••' •: RATE. .RLY EHQ Inspector: � �� _,� �� IN .1moi)=- EHD 23-04 U'" Rev 4/30/12 UST SERVICE RST INSPECTION REPORT