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Time In: <br /> Time Out: <br /> Boa !44 San Joaquin County <br /> 10 <br /> `q, Environmental Health Department <br /> _ _ 1868 East Hazelton Avenue , Stockton , CA95205-6232 <br /> . �4 . , ; , . .;p Telephone: (209) 468 -3420 Fax: (209 ) 464-0138 Web: www, sjgov. org/ehd <br /> � fFdRd <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: ARCO AM PM Date : 10/03/2017 <br /> Address : 1329 ESCALON AVE , ESCALON 95320 <br /> Requestor: PAUL RAJ , CHADHA CONSTRUCTION Telephone: (209 ) 595-0787 <br /> Program Element : 2303 - UST/PIPING INSTALLATION Request #: SR0074800 <br /> Inspection Type: 131 - UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Engel Molina ( installer) ICC Service TecWlnstaller Exp . Date : 02/08/2018 <br /> Manufacturer training : <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections : <br /> -Verified VPH components were installed on the 87 fill sump. The gasket seal on the fill sump lid was observed partially <br /> detached from the lid and laying in the gravel . Engel Molina pushed the gasket back under the fill sump lid at the time of <br /> inspection . <br /> The site is approved to receive fuel deliveries . <br /> "Additional inspections are needed . See the permit approval letter dated December 15 , 2016 for a complete list of inspections <br /> required . All appointments must be scheduled at least 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 Safei <br /> 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 10/03/2017 <br /> EHD 23-01 Rev, 06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />