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S A N J Q Q Q U IN Environmental Health Department <br /> COUNTY <br /> Greorness grows here. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: LOVES COUNTRY STORES OF CALIFORNIA#223 Date: 08/25/2022 <br /> Address: 1553 COLONY RD , RIPON 95366 <br /> Requestor: JAMIE BARNES, HFA Telephone: (405)687-1060 <br /> Program Element: 2308-UST RETROFIT Request#: SR0084412 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Cesar Ibarguen ICC Service Tech/Installer Exp. Date: 11/05/2022 <br /> Manufacturer training: Xerxes, 06/01/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> Amended inspection report to update the activity date to 8/25/2022. <br /> On site for the installation of new LISTS <br /> -Three 30,000 gallon base Xerxes double-walled fiberglass <br /> - Inside of tanks was inspected by the contractor on site and stated to be clean and brine-free. <br /> -Verified the use of the manufacturer installation checklist at the time of inspection. <br /> -Verified presence of deadmen and use of anchor straps. <br /> -Verified use proper pea gravel backfill. <br /> -Witnessed tanks set. <br /> -Witnessed beginning of backfilling of the tank pit and compaction of pea gravel. <br /> "Additional inspections are required. Refer to the approval letter for a list of inspections needed. <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: Emailed to Greg McLucas, Contracto <br /> EH Specialist: KRISTINA SAETERN Phone: (209)616-3045 <br /> FA0012659 SR0084412 SC298 08/25/2022 <br /> EHD 23-01 Rev.07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />