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SANJOANIN <br />COUNTY <br />Environmental Health Department <br />Time In: 11:00 am <br />Time Out: 12:00 pm <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: VALLEY PACIFIC HWY99 CARDLOCK <br />Date: 04/29/2021 <br />Address: 3550 S HWY 99 , STOCKTON 95215 <br />Requestor: NIC POBLANO, VALLEY PACIFIC PETROLEUM SERVICES <br />Telephone: <br />(209) 639-2191 <br />Program Element: 2308 - UST RETROFIT <br />Request #: <br />SR0083272 <br />Inspection Type: 001 - ROUTINE INSPECTION - Operating Permit <br />Onsite Service Technician: Jason Chamblin <br />FICC Service Tech/Installer Exp. Date: <br />05/14/2021 <br />Manufacturer training: OPW, 09/30/21 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for the following: <br />• Verified 5 gallon capacity <br />• Witnessed 1 hour hydrostatic test <br />• Verified proper drainage <br />Facility is approved to receive fuel in the 87 tank. <br />A secondary containment test must be performed on the 87 tank. Provide a 48 hour notification to ust@sjgov.org to <br />schedule this inspection. <br />To minimize person to person contact EHD is choosing to write the name of person receiving the report instead of having them <br />sign. Starting September 1, 2018, all in -office CERS help will be provided at EHD hourly rate ($152). To schedule an <br />appointment, please call (209) 468-3420. <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: <br />EH Specialist: FREDERICK ERNEST <br />Name and Title: Mike Eliason, Cardlock Manager <br />Phone: (209) 616-3026 <br />FA0007030 SR0083272 SCO01 04/29/2021 <br />EHD 23-01 Rev. 09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />