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Time In: <br /> Qac ty. San Joaquin County of Time Out: <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web.www.sigov.or-0/eh <br /> ig. I '*, <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: LODI ME. 1-iC)SPI1 I AL Date: M./30/2015 <br /> Address: SFAIRMON- AVE. LOD 94240 <br /> Requestor-. (,,AR1Rfl;E' �I-LI"TE �V CON-t'RAC.7-()RS INC Telephone. ,'2(.")91 4-E,,"l <br /> Program Element: "'.1,1308 d RE 'ROFF- Request#: F",X0(1 17 3_s4 <br /> 5 <br /> I Inspection Type: 298- ,JillRETROFII REPA�Rlt',,ISPE( ION <br /> Onsite Service Technician: Jose,hBad,'hvfldH IGG Service FectInstaller Exp. Date: 08/05112016 <br /> Manufacturer training: veed,,,- rool-0128/17 <br /> OVERALL WSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On sifie to stint c'fionaftyv st,-.a- the S I. S2. and S' ,,,ph snnart sensms. S2 is 'Dmnd ,nevV, 3 n le-del untrbe� <br /> 033211 7J,00 I and z^qeriz-fl nUmber 1 120'313131,. S1 and S3 ate exisbng All pass the, 'nc,,, vac[,,,jm r.,ind Ngh 1xl [ests. <br /> The person in charge is responsible for ensuring that the above me4oned facility is in compliance with all ap licable sectionof the California Health and <br /> Safety Code.If a reinspection is required,fees will be assessed at J$e current hourly rate. <br /> 41/ <br /> 4 0 <br /> Received by: Name and Title: Z j IL <br /> 0 <br /> EH Specialist-. ARIS. VELOS Phone-. (209)468-3,453 <br /> \T� <br /> FA 13 SR0073345 SC298 10C.M015 <br /> EHD 23-01 Rev.OSM15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />