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f MJ Q A Q I I I N Environmental Health Department <br /> COUNTY �Y <br /> Greol less grows here. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: COSTCO WHOLESALE#658 Date: 08/24/2022 <br /> Address: 3250 W GRANT LINE RD ,TRACY 95377 <br /> Requestor: M.ALEXIA INIGUES, BARGHAUSEN CONSTULTING ENGINEERS INC Telephone: (425)251-6222 <br /> Program Element: 2303-UST/PIPING INSTALLATION Request#: SR0083815 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Benjamin Getz ICC Service Tech/Installer Exp. Date: 01/07/2023 <br /> Manufacturer training: Tank Tester, 09/30/24 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site inspection: <br /> -On site for set up and start of ELD testing <br /> -ELD testing will also be ran overnight and verification of overnight readings will be measured tomorrow. <br /> Please submit ELD test results to EHD. Passing ELD test results must be received prior to approval to receiving fuel. <br /> Additional inspections are required, please see approval letter dated May 18, 2022-section 5 for additional inspections. <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. <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: <br /> EH Specialist: CAROL PRESTO Phone: (209)616-3061 <br /> FA0013810 SR0083815 SC298 08/24/2022 <br /> EHD 23-01 Rev.07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />