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SANOAQU I N Environmental Health Department <br />COU NI T Y I Y Time In: <br />+_,fr Time Out: <br />Greotr+ess �row3 here. <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: CRUISERS MANTECA #29 <br />Date: 11/15/2021 <br />Address: 1137 W LATHROP RD, MANTECA 95336 <br />Requestor: BZ MAINTENANCE, BZ MAINTENANCE <br />Telephone: (916) 371-2380 <br />Program Element: 2308 - UST RETROFIT <br />Request #: SR0084216 <br />Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br />Onsite Service Technician: Rhome Desbiens <br />ICC Service Tech/Installer Exp. Date: 12/10/2022 <br />Manufacturer training: FF, 03/12/23 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for the following inspections 87, 91 and diesel drop tubes: <br />1) Overfill prevention equipment verification: <br />- Measurement of drop tubes, set at 94% tank volume, checked with tank charts <br />- Verified flapper functionality <br />- Replaced 87 spill container <br />- Verified ball floats, ball floats installed, Service Technician removed ball floats in 87 and 91 tanks. <br />*-Ball float in diesel tank could not be removed- pending. <br />2) 87 Spill bucket test: <br />- Verified 5 gallon capacity <br />- Verified drainage <br />- Witnessed one hour hydrostatic test- passed. <br />This facility is approve to receive fuel in the 87 and 91 tanks. <br />* This facility is NOT approve to receive fuel in the diesel tank. <br />* Please log into CERS and update diesel tank capacity to 12 000 gallons and premium tank Capacity to 8 000 gallons. <br />* Additional inspection required to verify diesel tank ball float removed send notification to: ust@sjgov.org.To minimize person <br />to person contact EHD is choosing to write the name of person receiving the report instead 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: <br />EH Specialist: PAUL NSO <br />Name and Title: Monica Farhat, Environmental Contac <br />Phone: (209) 616-3049 <br />FA0019793 SR0084216 SC298 11/15/2021 <br />EHD 23-01 Rev. 09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />