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SAN JOAHI Environmental Health Department <br /> C U NTY Time In: <br /> Time Out: <br /> ' SS grows hojr <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: CHEVRON SS #372736 Date: 11/08/2019 <br /> Address: 9484 WEST LANE , STOCKTON 95210 <br /> Requestor: LIDDY MCKENZIE, GETTLER RYAN INC. Telephone: (925) 551-7555 <br /> Program Element: 2308- UST RETROFIT Request#: SR0080446 <br /> Inspection Type: 298- UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Raymond Simms ICC Service Tech/Installer Exp. Date: 06/25/2020 <br /> Manufacturer training: VMI, 12/10/20; OPW,03/14/20 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following: <br /> -Verified monitoring system and sensors functionality-all passed <br /> -Verified system leak detector test-all passed <br /> - Overfill prevention: Verified 95% tank volume shut off. Tanks set at 95% tank volume shut off. <br /> -Verified flapper functionality. <br /> -Verified Ball Floats- No Ball floats present. Service Technician stated he removed ball floats <br /> -Verified dispenser footprints, piping and fuel filters drainage into UDCs. Deflector plates not yet installed. <br /> -Secondary containment of UST system not performed since tanks annular space is brine filled and are on continuous <br /> monitoring. <br /> NB. Secondary containment testing for the UDCs, and all product piping is required on April 2020 ( 6months after initial <br /> testing.). <br /> Provide photos of all UDCs installed with deflector plates . <br /> This facility is approved to operate the UST system. <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: Donald Baughn, Service Tech <br /> EH Specialist: PAUL NSO Phone: (209)468-3432 <br /> SR0080446 SC298 11/08/2019 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />