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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: 12667 N MUNDY LN Date: 11/18/2019 <br /> Address: 12667 N MUNDY LN , LODI 95240 <br /> Requestor: MARTIN THORPE, JIM THORPE OILINE Telephone: (209)329-5481 <br /> Program Element: 2304-UST REMOVAL Request#: SR0081314 <br /> Inspection Type: 134-UST REMOVAL INSPECTION <br /> Onsite Service Technician: James Thrope ICC Service Tech/Installer Exp. Date: <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for a 350 gallons tank removal. The tank was initially thought to be a diesel tank, but was found to actually be a <br /> gasoline. <br /> -Witnessed tank removal and sampling. <br /> -Tank pit: 5ft.x 7 ft.x 5 ft.,with 2 ft. of the long side extended under the building (garage). <br /> Soil stockpile: approximately 3 cubic yards <br /> The soil was placed back into the tank pit. <br /> -Tank was inerted using 56.45 lbs. of dry ice. <br /> LEL: 1.0 <br /> 02: 1.9 <br /> -Sampling was conducted by Geoanalytical Laboratories <br /> -Sampler: Richard Chrun <br /> -Two stockpile samples were taken, labeled 'SPEast'and'SP West' <br /> -One sample was taken into native soil below the tank, at a depth of 8 ft., labeled 'TK at 8ft' <br /> -No noticeable staining or discoloration was observed. The sampler stated no odor was found. <br /> -Discussed sampling and analytical requirements with the sampler, referencing the sampling protocols approved in the permit. <br /> -Tank was cleaned out and triple rinsed prior to arrival. One 15 gallon drum of rinseate was observed on site labeled as <br /> hazardous waste. <br /> -Witnessed spray painting of the tank ID(39-0520865)on the side of the tank. <br /> -Verified that a fire permit was obtained prior to removal. <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: martin thorpe, vp <br /> EH Specialist: SHEWIT WOLDEAREGAY Phone: (209)468-0216 <br /> SR0081314 SC134 11/18/2019 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />