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?°`R¢—•E�''�P� <br />SAN JOAQUIN COUNTY <br />e .• :—car— , 'tZ.� <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Facility Address: <br />Telephone: (209) 468-3420 Fax. (209) 468-3433 Web: www.sigov.org/ehd <br />2512 E. Waterloo Rd., Stockton <br />SR0061062 <br />UNDERGROUND STORAGE TANK (UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br />Facility Name: <br />Inspection Date: <br />Waterloo Liquors <br />Thursday, September 30, 2010 <br />Facility Address: <br />Service Request* <br />2512 E. Waterloo Rd., Stockton <br />SR0061062 <br />Onsite Service Technician's Name: <br />ICC Service Technician/Installer Exp. Date: <br />Manufacturer Training: <br />Jesus Vera <br />15259508UT 5/5/2012 <br />DPM Split Repair (1/21/2012) <br />SERVICE <br />Leak detector <br />❑ <br />❑ mechanical Model: <br />❑ electronic Serial #: <br />❑ line test programmed <br />❑ <br />Leak detector <br />❑ <br />❑ mechanical Model: <br />❑ electronic Serial #: <br />❑ <br />❑ line test programmed <br />Leak detector <br />❑ <br />❑ mechanical Model: <br />❑ <br />❑ electronic Serial #: <br />❑ line test programmed <br />sensor <br />❑ <br />❑ positive shutdown Model: <br />❑ fail safe Serial #: <br />❑ <br />❑ NA <br />sensor <br />❑ <br />❑ positive shutdown Model: <br />❑ <br />❑ fail safe Serial #: <br />Q <br />❑ NA <br />sensor <br />❑ <br />❑ positive shutdown Model: <br />❑ fail safe Serial #: <br />❑ NA <br />❑ <br />Drop tube with mechanical overfill at 95% <br />❑ <br />Drop tube with mechanical overfill at 95% <br />❑ <br />Overfill prevention (see LIS letter 150-1) <br />SERVICE <br />Spill bucket ❑ minimum 5 gallon <br />❑ <br />❑ 1 hour hydrostatic ❑ Incon TS -STS <br />❑ Caldwell System ❑ Other <br />Spill bucket ❑ minimum 5 gallon <br />❑ <br />❑ 1 hour hydrostatic ❑ Incon TS -STS <br />❑ Caldwell System ❑ Other <br />Spill bucket ❑ minimum 5 gallon <br />❑ <br />❑ 1 hour hydrostatic ❑ Incon TS -STS <br />❑ Caldwell System ❑ Other <br />Primary piping testing at: <br />❑ <br />psi <br />minutes <br />Secondary containment testing for: <br />UDC(s) Piping <br />Sump(s) UST(s) <br />❑ <br />Testing for the above components are next due by: <br />Note: Please be aware that 2° containment components are required to be tested upon <br />installation, 6 months after, and every 36 months thereafter. <br />❑ <br />Cold start of monitoring panel <br />❑ <br />Corrosion protection <br />Q <br />Other: see below <br />Observed installation of DPM repair boot for the 91 -octane fuel line in #3/4 Dispenser of the UDC. <br />Technicians (Jesus and Alex) stated that the repair boot for the 91 -octane fuel line in the #1/2 <br />Dispenser will not be installed today. Technicans pointed out to me that screw holes had been drilled <br />into the #1/2 Dispenser UDC by unknown contractors in the past; therefore they do not believe the <br />91 -octane fuel line will pass the secondary containment test even if they replaced the boot. Darren of <br />Franzen Hill stated on the phone an addendum to the work plan will be submitted to EHD today or <br />tomorrow. Secondary containment tests on the fuel lines were not performed today. <br />THIS FACILITY IS SUBJECT TO REINSPECTIOW ANY TI AT EHD'S CURRENT HOURLY RATE. <br />LEHDI ped r. � / v Received Title: <br />M <br />2z — - <br />EHD 23-04 UST SERVICE REQUEST INSPECTION REPORT <br />Rev 06/01/10 <br />