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96/"LU/LUUY TKU 14: L7 t'AX [U�= tl3433 <br />********************* <br />*** FAX TX REPORT *** <br />********************* <br />TRANSMISSION OK <br />JOB NO. <br />DESTINATION ADDRESS <br />PSWD/SUBADDRESS <br />DESTINATION ID <br />ST. TIME <br />USAGE T <br />PGS. <br />RESULT <br />5UV Znu <br />2822 <br />94654988 <br />Henderson Maint Co <br />08/20 14:19 <br />05' 50 <br />9 <br />OK <br />JoaquinSan <br />Environmental Health Department <br />.I1 East Main Street <br />Stockton,California95202-3029 <br />August 19, 2009 <br />Phone:1' 468-3420 i <br />i' 464 71 <br />: <br />Carl Wayne Henderson <br />Henderson Maintenance Company <br />P. O. Box 31325 <br />Stockton, CA 95213 <br />Fax: 209-4654988 <br />DIRECTOR <br />Donna Heran, REHS <br />ASSISTANT DIRECTOR <br />Laurie Cotulla, REHS <br />PROGRAM COORDINATORS <br />Mike Huggins, REHS, RDI <br />Margaret Lagorio, REHS <br />Robert McClellon, REHS <br />Jeff Carruesco, REHS, RDI <br />Kasey Foley, REHS <br />Sent via Fax and Mail <br />Subject: El Dorado Food Mart, 2320 N El Dorado Street, Stockton, CA (SR0058096) <br />The San Joaquin County Environmental Health Department (EHD) has completed the review of <br />the application for a permit to install a Veeder Root 794380-303 sensor in the 91 product tank <br />annular space. The permit has been approved with the following conditions: <br />Conditions of approval: <br />1. Contact the local fire department, local planning or building department and the San <br />Joaquin Valley Air Pollution Control District for any applicable permits. <br />2. Any changes shall be submitted to the San Joaquin County Environmental Health <br />Department (EHD) for approval prior to commencing work. All new addenda supercede <br />the previous ones. <br />3. When the alarm history is cleared by the cold start, an alarm history printout must be <br />created before the cold start and available for EHD inspection. <br />4. Contact Garrett Backus (209-468-2986) to arrange the following inspection(s) (a 48-hour <br />notice is required): <br />a. Functionality test of the liquid sensor. <br />5. A "Certification of Installation / Modification" form shall be submitted by the owner or <br />the owners' agent [pursuant to (CCR) 2635(d)] before this upgrade will be considered <br />complete by EHD. <br />6. All components must be certified by an independent testing organization and labeled as <br />required by the organization. (UL, ULC, ANSI, API, ASTM, etc. See California Code of <br />Regulations (CCR), Title 23 Chapter 16 Table B for complete list). The component must <br />I----'`1-- ----------'1-- .--"-1- -- --" f..- 1 t. A t , ,. <br />l,l <br />-uU1 <br />