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VAN DE POL Fax:2094661910 Aug 2 2013 16:49 P.06 <br />.. �. ..,.; .: •s•,. .... .. .... ,. .� •s'q, '�rotM. ,..q ••v,rrw ••,4. � P ix�'q•@� *+td J <br />:. .Y.�aN JOAQUlN CouNTY .w <br />' ^ ' ENviRONMENTAL HEALTH DEPARTRiIENT <br />.; 1868 East Hazelton Avenue, Stockton, CA 98205-8132 <br />reiephonee (20S) 468-3420 <br />}" 'Ja .20,3i .ka.cLqW <br />UNDERGROUND STD G TANK (UST} PROD M SERVICE REt 11E$`Y iN <br />SERVICE <br />Leak detector <br />I❑ <br />❑ mechanical Model:' <br />L electronic Serial #: <br />❑ line test programmed <br />❑ <br />Leak detector <br />❑ <br />®mechanical Model: <br />❑ electronic Serial.0: <br />❑ <br />d line test proarammed <br />sensor <br />® positive shutdown Model: <br />❑ fail safe . ' . aerial #: <br />❑'NA <br />❑ <br />sensor <br />❑ "positive shutdown Model: <br />1] <br />11 fail safe Serial #: <br />©. <br />❑ NA <br />sensor <br />❑ . <br />❑ positive shutdown Model: <br />0: fail safe Serial <br />❑ NA <br />® <br />Drop tube with mechanical overfill at 95% <br />® <br />Drop tube with mecherrir-al overfill &t95% <br />®' <br />Overfill prevention (see LG letter 1'50-1) <br />1I[tT-1RFAWTT*ff'M "MIJUAllig <br />SERVICE <br />Sipill bucket ❑ minimum 5 gallon <br />❑ <br />El 1hour hydrostatic 0 Incori TS -STS <br />❑ Cald�eH System ❑ Other' <br />r..._._ Spill bucket ❑ minimum 6 gallon <br />❑ <br />❑ 1 hour hydrostatic ❑ Incon TS -STS <br />❑ Calda ell System ❑ Other <br />Prlmaryplping testing at <br />❑ <br />psi <br />Minutes <br />Secondary containment testing; tor. <br />UDC(s) piping <br />Sumps) UST(s) <br />❑ <br />-Testing for the above components are next due by: <br />Now. Pwass be = mat r Bent mn aw"nents are requ�sd to be tested upon <br />a+ tin 0 mmft afw, and am W teo" ftmftar, <br />1] <br />Cold:strt of mt9nitoring.pane! <br />©. <br />Corrosi4n protection <br />Other: dee below <br />r-1 This US! T facility is NOT .O, • to o.: <br />va _ <br />�� ■ISO <br />{ <br />