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SAN JOANI Environmental Health Department <br /> COU N T Time In: <br /> Time Out: <br /> (',reotr+ess grows ho,— <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: FLAG CITY SHELL* Date: 09/24/2020 <br /> Address: 6437 BANNER ST , LODI 95242 <br /> Requestor: MEGAN MITCHELL, ELITE IV CONTRACTORS Telephone: (209)467-6337 <br /> Program Element: 2308- UST RETROFIT Request#: SR0081753 <br /> Inspection Type: 298- UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Michal Kennard ICC Service Tech/Installer Exp. Date: 06/19/2021 <br /> Manufacturer training: Bravo, 04/02/22 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following: <br /> -Verified dispensers footprint contained by the under dispenser containment sumps(UDCs), fuel filters drain directly into <br /> UDCs. <br /> -Verified piping within the dispensers no evidence of any leaks <br /> -Verified Installation of Bravo Conversion frames <br /> *The tank owner or operator shall log into the California Environmental Reporting System (CERS) and ensure all <br /> UST information is current. <br /> *This facility is approve to operate the UST system after functionality of the monitoring system is restored to normal. <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: Michal Kennad, Service Tech <br /> EH Specialist: PAUL NSO Phone: (209) 616-3049 <br /> FA0007140 SR0081753 SC298 09/24/2020 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />