Laserfiche WebLink
N.qu 111Y.. <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)468-3433 Web:www.sjgov.org/ehd <br /> C�fiQ'�iea <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM SERVICE REQUEST INSPECTION REPORT <br /> Facility Name: Inspection Date: <br /> Valley Pacific Petroleum 1/22/2021 <br /> Facility Address: Service Request#: <br /> 1524 Fresno Avenue, Stockton, CA 95206 SR0083189 <br /> Onsite Service Technician's Name: ICC Service Technician/Installer Exp.Date: Manufacturer Training: <br /> Josh Simmons 01/15/2022 OPW 1/21/2023 <br /> SERVICE SERVICE <br /> Leak detector DSL Spill bucket ❑ minimum 5 gallon <br /> ❑ ❑ mechanical Model: ❑X ❑ 1 hour hydrostatic ❑ Incon TS-STS <br /> ❑ electronic Serial#: ❑ Caldwell System 0 Other <br /> ❑ line test programmed <br /> Leak detector Spill bucket ❑ minimum 5 gallon <br /> ❑ mechanical Model: <br /> ❑ El ❑ 1 hour hydrostatic ❑ Incon TS-STS <br /> ❑ electronic Serial#: ❑ Caldwell System El Other <br /> 11 line test programmed <br /> sensor <br /> E] ❑ positive shutdown Model: El psi piping testing at: <br /> ❑ fail safe Serial#: p <br /> ❑ NA minutes <br /> sensor Secondary containment testing for: <br /> ❑ ❑ positive shutdown Model: UDC(s) Piping <br /> ❑ 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 20 containment components are required to be tested upon <br /> ElNA 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% j ❑ Corrosion protection <br /> ❑ Overfill prevention (see LG letter 150-1) ❑ Other: see below <br /> ❑ This UST facility is APPROVED to operate ❑X This UST facility is NOT APPROVED to operate <br /> On site to witness corrosion protection for the diesel direct bury spill bucket. <br /> Riser is taped with 3M tape. <br /> Additional inspections required: <br /> - Spill bucket test: verify minimum 5 gallon capacity and pass a one hour hydrostatic test (or <br /> equivalent). Proper drainage must also be verified. <br /> - Secondary Containment test on diesel tank due to concrete being broken. <br /> This facility is not approved to receive fuel in the diesel tank. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> EHD Inspector: Carol Presto,EHST Received By: Title: <br /> EHD 23-04 Rev.04/19/12 UST SERVICE REQUEST INSPECTION REPORT <br />