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Time In: <br /> Time Out: <br /> opQ.�tN. San Joaquin County <br /> .X Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> �<<FORtN <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: C-STORE W/76 FUEL ISLAND Date: 05/21/2020 <br /> Address: 141 E HARNEY LN , LODI 95240 <br /> Requestor: MEL HIGGINBOTHAM, PM DESIGN GROUP INC Telephone: (530)303-2814 <br /> Program Element: 2303-UST/PIPING INSTALLATION Request#: SR0079417 <br /> Inspection Type: 131 -UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Ricardo Gonzalez ICC Service Tech/Installer Exp. Date: 05/01/2021 <br /> Manufacturer training: Tank Tester, 05/31/20 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following: <br /> -Witnessed the start of Enhanced Leak Detection (ELD)testing. <br /> -Discussed pre-testing and testing procedures with Ricardo Gonzalez of Leak detection Technologies. <br /> *Additional inspections are needed. Refer to the approval letter for a list of required inspections. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead of having them <br /> sign. <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: Ricardo Gonzalez, Tank Tester <br /> EH Specialist: SHEWIT WOLDEAREGAY Phone: (209)468-0216 <br /> SR0079417 SC131 05/21/2020 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />