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Time In: <br /> Time Out: <br /> ,oP . �o San Joaquin County <br /> y:. Environmental Health Department <br /> _ ej 1868 East Hazelton Avenue , Stockton , CA95205- 6232 <br /> c •. . — �P Telephone: (209 ) 468-3420 Fax: (209 ) 464 -0138 Web: www. sjgov . org/ehd <br /> q�f P ORS <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility : ARCO AM PM Date : 01 /04/2017 <br /> Address : 1329 ESCALON AVE , ESCALON 95320 <br /> Requestor: PAUL RAJ , CHADHA CONSTRUCTION FRequest4 : <br /> ne: (209 ) 595 -0787 <br /> Program Element: 2303 - UST/ PIPING INSTALLATION SR0074800 <br /> Inspection Type: 131 - UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Engel Molina ICC Service Tech/Installer Exp . Date : 02/08/2018 <br /> Manufacturer training : Containment Solutions Inc , 02/03/ 17 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections : <br /> - Inspection of the 10 , 000 gallon and 20 , 000 gallon doublewalled fiberglass tanks for brine leaks prior to tank placement in <br /> excavation - none observed . <br /> -Verified UL markings were listed on the tanks. <br /> -Verified field-completion of the Containment Solutions , Inc. ( CSI ) tank pre-installation checklist. <br /> -Witnessed tank setting in the excavation . <br /> -Verified anchorage was installed in accordance with the approved , engineered plans , including deadmen installation. <br /> -Verified corrosion protection on all exposed metal parts - both galavanized paint coating and tar were used on the metal <br /> portions of the anchor straps and connectors . <br /> -Verified approved backfill ( pea gravel ) is being used and witnessed partial backfilling around the tanks . <br /> "Additional inspections are needed . See the permit approval letter dated December 15 , 2016 for a complete list of <br /> inspections required . All appointments must be scheduled 48 hours in advance . <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 /> Received by : Name and Title: Engel Molina , Installer <br /> EH Specialist : STACY RIVERA Phone : (209 ) 468 -3440 <br /> FA0000293 SR0074800 SC131 01 /04/2017 <br /> EHD 23-01 Rev. 06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />