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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: 05/18/2021 <br /> Address: 34243 S CHRISMAN RD , TRACY 95304 <br /> Requestor: DEBORAH JONES, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2309-UST RETROFIT-Minor Plan Check Request#: SR0083263 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Joseph Bartholdi ICC Service Tech/Installer Exp. Date: 04/13/2023 <br /> Manufacturer training: NOV, 02/14/22 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness primary pipe testing for the diesel product piping between dispensers 13 and 14. <br /> -verified pressure gauge functionality <br /> -witnessed primary piping soap test <br /> -witnessed 1 hour pneumatic pressure test <br /> All components tested passed. <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 05/18/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />