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r: � I I I Environmental Health Department <br />Y SA N U <br />rTz wti COUNTY Time In: <br />Time Out: <br />Greorness grows here, <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: CRUISERS MANTECA #29 <br />Date: 11/17/2021 <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 inspection on the diesel tank. <br />Verified ball float. <br />- Ball float installed. The service technician removed installed ball float. <br />This facility is approve to receive fuel in the diesel tank. <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: <br />EH Specialist: PAUL NSO <br />Name and Title: E mailed report to: Monica Farhat, En <br />Phone: (209) 616-3049 <br />FA0019793 SR0084216 SC298 11/17/2021 <br />EHD 23-01 Rev. 09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />