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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 /> ey—Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: 7-ELEVEN#41216 Date: 05/25/2021 <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: Brent Bowen ICC Service Tech/Installer Exp. Date: 06/17/2021 <br /> Manufacturer training: OPW, 01/05/22;VR, 04/23/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following: <br /> -witnessed testing of monitoring system functionality <br /> -witnessed 1 hour hydrostatic spill container test for the diesel, premium, and regular <br /> -verified 5 gallon capacity for the diesel, premium, and regular spill containers <br /> -verified proper drainage for the diesel, premium, ad regular spill containers <br /> -verified the overfill prevention measurements for the OPW fill tube shut-off valves are set at 95%for the diesel, premium, and <br /> regular <br /> -verified communication at the end point of the vacuum zones for the diesel, premium and regular fill sumps <br /> -verified the installation of vacuum, pressure, or hydrostatic(VPH)components <br /> All components tested passed. <br /> This site is approved to receive fuel. This site is NOT approved to operate. Please refer to the permit approval letter for the <br /> required inspections that are still needed. Provide a 48 hour notice to the EHD by emailing ust@sjgov.org. <br /> To minimize person to person contact the EHD is choosing to write the name of person receiving the report instead of having <br /> 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 Daile Adams, Contractor <br /> EH Specialist: VICKY VANG-LEE Phone: (209)616-3028 <br /> SR0082094 SC131 05/25/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />