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r SANJOAQUI Environmental Health Department <br />C U T Time In: Time Out: <br />Greatness grows here, <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: Harney Lane 76 <br />Date: 02/28/2022 <br />Address: 141 E HARNEY LN , LODI 95240 <br />Requestor: MARGARET SMITH, BZ MAINTENANCE <br />Telephone: (916) 371-2380 <br />Program Element: 2308 - UST RETROFIT <br />Request #: SR0084838 <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: OPW, 05/08/22 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site to witness the overfill prevention equipment (drop tube with shut-off valve) installation on the 87, 91, and diesel <br />underground storage tanks. <br />Verified tank charts and calculations. <br />Verified flapper functionality. <br />Verified there are no ball floats installed. <br />This facility is approved to receive fuel in the 87, 91, and diesel tanks. <br />Submit the overfill prevention equipment inspection report form to the Environmental Health Department within 30 days. <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. Starting September 1, 2018, all in -office CERS help will be provided at EHD hourly rate ($152). To schedule an <br />appointment, please call (209) 468-3420. <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: VICKY VANG-LEE <br />Name and Title: Emailed to Margaret Smith, Contracto <br />Phone: (209) 616-3028 <br />FA0024750 SR0084838 SC298 02/28/2022 <br />EHD 23-01 Rev. 09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />