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SAN J O A Q U I N Environmental Health Department <br /> —COUNTY— Time In: <br /> Time Out: <br /> i�C1FaR'' GreQl tress grows her— <br /> Underground <br /> er .Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: 7-ELEVEN#41216 Date: 04/05/2021 <br /> Address: 770 W CHARTER WAY, STOCKTON 95206 <br /> Requestor: CRYSTAL JUSTICE-CONSTRUCTION MANAGER, 7-ELEVEN INC Telephone: (916)742-0232 <br /> Program Element: 2303-UST/PIPING INSTALLATION Request#: SR0082094 <br /> Inspection Type: 131 -UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Jesse Nelson ICC Service Tech/Installer Exp. Date: 02/12/2022 <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness primary piping test. <br /> -witnessed soap testing of all primary piping <br /> -verified functionality of all gauges <br /> -witnessed 1 hr pneumatic pressure test in accordance to manufacturer installation instructions <br /> -all components tested passed <br /> Manufacturer's certification for the NOV Fiberglass piping was not provided at the time of the inspection. Please provide <br /> manufacturer certifications for Jesse Nelson immediately. Certification with an issue date after the date of testing will not be <br /> accepted. <br /> If certification is not provided,the primary piping test will need to be repeated by a certified ICC installer who is certified in the <br /> manufacturer of the component. <br /> The primary tank test has not been performed. This test needs to be conducted immediately with the EHD present to witness <br /> the testing. Provide a 48 hour not ice to the EHD by emailing ust@sjgov.org. <br /> To minimize person to person contact, the EHD is choosing to write the nameof the person receiving the report instead of <br /> having them sign. <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: Emailed to Dale Adams, Contractor <br /> EH Specialist: VICKY VANG-LEE Phone: (209)616-3028 <br /> SR0082094 SC131 04/05/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />