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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: 09/02/2022 <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: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Juan Delgado ICC Service Tech/Installer Exp. Date: 08/05/2024 <br /> Manufacturer training: NOV, 01/23/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On-site to witness: <br /> Secondary piping pressure testing. <br /> Soap testing of all piping and penetrations. <br /> Integrity testing of all sumps, one hour pressure testing <br /> Site is NOT approved to pour concrete, see permit for requirements. <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; Richard Walton, C <br /> EH Specialist: FREDERICK ERNEST Phone: (209)616-3026 <br /> SR0083599 SC298 09/02/2022 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />