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r: � I I I Environmental Health Department <br /> Y SA N U <br /> rk.1 wti COUNTY Time In: <br /> Time Out: <br /> Greotr+ess �rGws here, <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: COSTCO WHOLESALE#658 Date: 07/28/2022 <br /> Address: 3250 W GRANT LINE RD ,TRACY 95377 <br /> Requestor: M.ALEXIA INIGUES, BARGHAUSEN CONSULTING ENGINEERS INC Telephone: (425)251-6222 <br /> Program Element: 2308-UST RETROFIT Request#: SR0084603 <br /> Inspection Type: 131 -UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Jiovanny Preciado ICC Service Tech/Installer Exp. Date: 01/18/2024 <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness primary pipe 1 hour pressure testing. <br /> Soap testing was conducted on primary piping. <br /> Both tests passed. <br /> Site is not approved to receive fuel. See permit dated May 18th, 2022. <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: Report emailed to;Austen Downey, P <br /> EH Specialist: FREDERICK ERNEST Phone: (209)616-3026 <br /> SR0084603 SC131 07/28/2022 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />