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Environmental Health Department <br /> SQN .JOQQUIN <br /> Time In: <br /> - - - - COUNTY — rime out: <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: WEST SIDE MARKET Date: 10/04/2019 <br /> Address: 741 N CENTRAL AVE , TRACY 95376 <br /> Requestor: JACK COOK ESTIMATOR/ PM , CVE CONTRACTING GROUP INC DBA CI Telephone: (925) 586-3317 <br /> Program Element: 2304 - UST REMOVAL Request #: SR0078722 <br /> Inspection Type: 303 - SAMPLING (No Charge) <br /> Onsite Service Technician N/A ICC Service Tech/Installer Exp, Date: <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On Site to witness soil sampling after Underground Storage tank (UST) tank removal . <br /> Witness Technicon Engineering Services Inc - Miguel Ceja (Environmental Technician) <br /> collect the following soil samples. <br /> Stock pile at approximately 2inches <br /> 1 ) Stock pile #1 @ 10. 15am <br /> 2) Stock pile #2 @ 10.22am <br /> 3) Stock pile #3 @ 10.22am <br /> 4) Stock pile #4 @ 10.24am <br /> At approximately 2feet deep at tank location <br /> 5) Sample 1 @ 10.30am <br /> 6) Sample 2 @ 10.33am <br /> 7) Sample 3 @ 10.35am <br /> Samples taken to the lab for analysis. <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 houdy rate. <br /> Received by: Name and Title: Greg Rodriquez Superintendent <br /> EH Specialist: PAUL NSO Phone: (209) 468-3432 <br /> FA0003200 SR0078722 S0303 10/04/2019 <br /> EHD 23-01 Rev. 06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />