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Environmental Health Department <br /> SAN-6-JOAQUIN <br /> vii fir : C 0 U ( T Time In: <br /> Time Out: <br /> r'�JFOSX;` Creotness grows Frere, <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: 3443 E CHEROKEE RD Date: 12/16/2019 <br /> Address: 3443 E CHEROKEE RD , STOCKTON 95242 <br /> Requestor: LESLIE BURNSIDE, BARGHAUSEN CONSULTING ENGINEERS INC Telephone: (858)610-0153 <br /> Program Element: 2303-UST/PIPING INSTALLATION Request#: SR0078758 <br /> Inspection Type: 131 -UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Chris Adams ICC Service Tech/Installer Exp. Date: 04/19/2020 <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following: <br /> -Verified the presence of test ports for all communication testing. <br /> -Verified leak monitoring communication for all piping (under vacuum), UDCs(brine), and sumps (brine). All passed. <br /> -Verified dispenser footprints contained by the UDCs and any potential piping or filter leaks drain into the UDCs. <br /> -Verified VPH component installation. <br /> -Verified external audible/visual alarm activates when tanks are 90%full. <br /> -Verified 5 gallon capacity and drainage for all three spill containers. <br /> -Witnessed one hour hydrostatic testing of all three spill containers. Passed. <br /> -Verified sensor functionality of all liquid and brine sensors, include vacuum liquid sensors. <br /> -Verified the site has an active CDTFA number. <br /> -Assisted the owner with CERS information. <br /> **This facility is APPROVED to RECEIVE FUEL, but is NOT APPROVED to OPERATE.** <br /> **Additional inspections are required. See the approval letter for a list of remaining inspections. <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: Donny Gilmer, Installer <br /> EH Specialist: STACY RIVERA Phone: (209)468-3440 <br /> SR0078758 SC131 12/16/2019 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />