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Q N Q N Environmental Health Department <br /> J Time In: <br /> N T Y <br /> Time Out: <br /> trrF yr0Oro S herr?- <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: Costco Wholesale #38 ( Gas Station ) Date : 03/04/2021 <br /> Address : 1630 E Hammer LN , STOCKTON 95210 <br /> Requestor: M . ALEXIA INIGUES , BARGHAUSEN CONSULTING ENGINEERS , INC . Telephone: (425 ) 251 -6222 <br /> Program Element: 2308 - UST RETROFIT Request # : SR0083323 <br /> Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Joshua Smith ICC Service Tech/Installer Exp , Date : 10/23/2022 <br /> Manufacturer training : NOV, 03/30/21 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following the inspection : <br /> - Visual inspection of piping within the vent sump. <br /> This facility is approve to receive fuel in the 87 Tank - 1 <br /> Secondary containment testing for the 87 turbine tank- 1 sump and vent sump is required six months after installation/repairs . <br /> Provide 48 hours notification to the EHD when this test is scheduled . <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of 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: Joshua Smith , Service Tech <br /> EH Specialist: PAUL NSO Phone : (209 ) 616-3049 <br /> FA0024496 SR0083323 SC298 03/04/2021 <br /> EHD 23-01 Rev. 09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />