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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: Costco Wholesale#1031 Date: 03/11/2020 <br /> Address: 2440 DANIELS ST , MANTECA 95336 <br /> Requestor: ALEXIA INIGUES, COSTCO WHOLESALE C/O BARGHAUSEN CONSULT Telephone: (425)251-6222 <br /> Program Element: 2308-UST RETROFIT Request#: SR0080347 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Isaac Anderson ICC Service Tech/Installer Exp. Date: 06/12/2020 <br /> Manufacturer training: VR, 10/22/20 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following: <br /> -Verified dispenser footprints contained by the UDCs. <br /> -Visually inspected piping under dispensers. No leaks observed. <br /> -Witnessed communication testing for all installed UDCs. Passed <br /> -Witnessed the start of sensor functionality and leak detectors testing. <br /> -Primary piping test was conducted yesterday(3/10/2020)and was not witnessed by EHD. Passed <br /> -Brine type and brine addition was not witnessed by EHD. <br /> -Tanks, sumps and UDCs were monitored. <br /> -As built plans were submitted by Mark Strockis while EHD was onsite. <br /> A copy of test report must be submitted within 30 days of the test. <br /> This facility is approved to operate. <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: Anthony Young, Superintendent <br /> EH Specialist: SHEWIT WOLDEAREGAY Phone: (209)468-0216 <br /> FA0018721 SR0080347 SC298 03/11/2020 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />