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r SANJOAQUI Environmental Health Department <br /> C U N T Time In:Time Out: <br /> Greatness grows here, <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: MORADA CHEVRON FAST N EASY#60* Date: 07/21/2021 <br /> Address: 10878 N HWY 99 , STOCKTON 95212 <br /> Requestor: JOHN BAYLIS, IEC SERVICES Telephone: (916)993-6312 <br /> Program Element: 2308-UST RETROFIT Request#: SR0083862 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Hayden Nunes ICC Service Tech/Installer Exp. Date: 01/14/2023 <br /> Manufacturer training: OPW, 01/05/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to verify corrosion protection on the direct-bury 91 spill container prior to backfilling. <br /> This service request is not complete at this time. <br /> NEEDED: <br /> -Spill container test:verify minimum 5-gallon capacity and pass a one hour hydrostatic test(or equivalent). <br /> -Verification of proper drainage <br /> -Secondary containment test must be performed on the 91 tank once concrete is poured in accordance to the manufacturer's <br /> guidelines <br /> NOTE: Please be aware that the facility cannot receive fuel in the 91 tank prior to the EHD inspection and approval. <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: Hayden Nunes, Service Tech <br /> EH Specialist: SHEWIT WOLDEAREGAY Phone: (209)616-3063 <br /> FA0001146 SR0083862 SC298 07/21/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />