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SANJI Environmental Health Department <br /> COU NTY Time In: <br /> Time Out: <br /> rrrws Ter!. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: CHARTER WAY SHELL* Date: 10/08/2019 <br /> Address: 620 W DR MARTIN LUTHER KING JR BLVD, STOCKTON 95206 <br /> Requestor: MEGAN MITCHELL, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2308- UST RETROFIT Request#: SR0080743 <br /> Inspection Type: 298- UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Micheal Kennard ICC Service Tech/Installer Exp. Date: 06/18/2021 <br /> Manufacturer training: OPW(SB), 05/23/21 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for 87 and diesel tank measurement of drop tubes to verify 95% tank volume shut off and spill container testing. <br /> - The 87 and diesel tanks set at 93% tank volume. <br /> -Witnessed 1(one) hour hydrostatic testing - Passed <br /> -Verified 5(five) gallon capacity- Passed <br /> -Verified drainage ok <br /> - No ball float on 87 and diesel tank- Service Technician Micheal Kennard stated. <br /> N.B. Service request amended scope of work: 87 and diesel tanks not 87 and 91. see file for details. <br /> This facility is approved to receive fuel in the 87 and diesel tanks. <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: Micheal Kennard, Service Techniciar <br /> EH Specialist: PAUL NSO Phone: (209)468-3432 <br /> FA0003738 SR0080743 SC298 10/08/2019 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />