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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: WATERLOO FOODMART Date: 07/10/2019 <br /> Address: 4315 E WATERLOO RD , STOCKTON 95215-2305 <br /> Requestor: MEGAN MITCHELL, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2308-UST RETROFIT Request#: SR0080525 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Joseph Bartholdi ICC Service Tech/Installer Exp. Date: 11/17/2019 <br /> Manufacturer training: NOV, 02/14/21 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness secondary piping soap test for the 87 product piping.The one hour pressure test was performed per <br /> manufacturer's guidelines at 5 psi. Test passed. <br /> This UST facility is NOT approved to operate. <br /> Still need: <br /> -line tightness test <br /> -verification of leak monitoring (vacuum)communication for the 87 piping <br /> NOTE: Please be aware that secondary containment testing for the 87 product piping is due by January 10, 2020 (6 months <br /> from today). <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: Joseph Bartholdi, <br /> EH Specialist: SHEWIT WOLDEAREGAY Phone: (209)468-0216 <br /> FA0003831 SR0080525 SC298 07/10/2019 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />