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SAN J O A Q U I ISIV I Environmental Health Department <br /> U IN 1 Y <br /> . Gre�trless grows he, . . <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: WOODBRIDGE AM PM* Date: 12/09/2022 <br /> Address: 18806 N LOWER SACRAMENTO RD ,WOODBRIDGE 95258 <br /> Requestor: CARRIE MILLER, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2309-UST RETROFIT-Minor Plan Check Request#: SR0086081 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Benjamin Malaspina ICC Service Tech/Installer Exp. Date: 06/17/2024 <br /> Manufacturer training: VMI, 08/30/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site witnessed: <br /> -The 87 and diesel product line leak detector testing. <br /> All passed. <br /> This facility is approve to operate the UST system. <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: E mail report to: Sandesh Bola, Envir <br /> EH Specialist: PAUL NSO Phone: (209)616-3049 <br /> FA0003607 SR0086081 SC298 12/09/2022 <br /> EHD 23-01 Rev.07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />