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S A N J Q Q Q U IN Environmental Health Department <br /> C O U N T Y Time In: <br /> Time Out: <br /> Greorness grows here. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: COUNTRY MART GAS& FOOD Date: 06/22/2021 <br /> Address: 34243 S CHRISMAN RD , TRACY 95304 <br /> Requestor: DEBORAH JONES, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2308-UST RETROFIT Request#: SR0083263 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: ICC Service Tech/Installer Exp. Date: <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness soil sampling. <br /> The sampler on site was Richard Marty of Advanced Geo Environmental. <br /> The following samples were taken. <br /> -4 soil samples were taken with a hand auger under each dispenser(D-1, D-2, D-3, D-4) <br /> -2 soil samples were taken from 1 stock pile approximately 50 cubic yards(SP-1, SP-2) <br /> The under dispenser containment(UDC)sumps and piping were all within the same trench which was approximately 56ft in <br /> length, 3ft in width, and 2.5ft in depth. <br /> The removed piping and UDCs were still on site at the time of soil sampling. Per Eric Monroy of Elite IV, the pipes will be triple <br /> rinsed at a later time and placed into hazardous waste drums. <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. <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 Debbie Jones, Contractor <br /> EH Specialist: VICKY VANG-LEE Phone: (209)616-3028 <br /> FA0003290 SR0083263 SC298 06/22/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />