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Time In: <br /> Time Out: <br /> �W San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �., y• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: 7-ELEVEN INC#19976 Date: 11/07/2017 <br /> Address: 1399 N MAIN ST, MANTECA 95336 <br /> Requestor: NICHOLAS ROWE, LC SERVICES Telephone: (559)444-1730 <br /> Program Element: 2308-UST RETROFIT Request#: SR0078217 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: ICC Service Tech/Installer Exp. Date: <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to observe the following inspections <br /> -Verification of the dispenser footprints contained by the under dispenser containment sumps(UDCs) <br /> -Visual inspection of the piping within the dispensers. <br /> -Verification of Bravo splash guard installation per the manufacturer's installation instructions. <br /> All passed. <br /> Was onsite with Nicholas Row from LC services. <br /> Bravo Certification: Expires 5/11/2019 <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: Nicholas Rowe, LC Services <br /> EH Specialist: JOHN ALANIZ Phone: (209)468-3147 <br /> FA0000916 SR0078217 SC298 11/07/2017 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />