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Time In: <br /> Time Out: <br /> a�a4fN. San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> a4.._ ....�a Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> �l FOR~ <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: JAHANT FOOD N FUEL STOP Date: 06/19/201' <br /> Address: 24323 N HWY 99 , ACAMPO 95220 <br /> Requestor: MEGAN MITCHELL, ELITE IV CONTRACTORS Telephone: (209)461-6342 <br /> Program Element: 2308 - UST RETROFIT Request#: SR0077671 <br /> Inspection Type: 296- UST PIPING REPAIR INSPECTION <br /> Onsite Service Technician Michal Kennard ICC Service Tech/Installer Exp. Date: 10/28/2018 <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> Witnessed secondary piping soap test and a one hour 5 PSI pressure test for the 89 product. Both tests had passing results <br /> A secondary containment piping pressure test, after surface repairs/restoration must be conducted, per service request <br /> SR0077671 approval letter dated June 12, 2017. <br /> A24 hour hydrostatic test(or equivalent) on any impacted/exposed UDC sump(s), as applicable per service request <br /> SR0077671 approval letter dated June 12, 2017. <br /> The person in charge is responsible for ensuring that the above mentioned facility is in compliance with all applicable sections of the California Health and <br /> Safety Code. If a reinspection is required,fees will be assessed at the current hourly rate. <br /> y� -* � <br /> Received by: Name and Title: Michal Kennard, Service Tech <br /> EH Specialist: CESAR RUVALCABA Phone: (209) 953-6213 <br /> FA0004345 SR0077671 SC296 06/19/2017 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />