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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: CHARTER WAY 76 Date: 07/21/2022 <br /> Address: 1720 S FRESNO AVE , STOCKTON 95206 <br /> Requestor: SARAH JABLONSKY,WALTON ENGINEERING, INC. Telephone: (916)373-1165 <br /> Program Element: 2303-UST/PIPING INSTALLATION Request#: SR0083599 <br /> Inspection Type: 131 -UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Juan Delgado ICC Service Tech/Installer Exp. Date: 08/31/2022 <br /> Manufacturer training: Xerxes, 01/02/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for tank pressure testing for the 87, 91 and diesel grades. <br /> Passed <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: Juan Delgado, Installer <br /> EH Specialist: FREDERICK ERNEST Phone: (209)616-3026 <br /> SR0083599 SC131 07/21/2022 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />