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SANOAQU I N Environmental Health Department <br /> COU NI T Y I Y Time In: <br /> + _,fr Time Out: <br /> . •- Greotr+ess �row3 here, <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: 7-ELEVEN INC Date: 03/04/2022 <br /> Address: 1110 N MAIN ST , MANTECA 95336 <br /> Requestor: CRYSTAL JUSTICE, 7-ELEVEN Telephone: (916)742-0232 <br /> Program Element: 2303-UST/PIPING INSTALLATION Request#: SR0083066 <br /> Inspection Type: 131 -UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Dale Adams ICC Service Tech/Installer Exp. Date: 03/04/2023 <br /> Manufacturer training: Xerxes Tank, 08/01/22 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the installation of new LISTS <br /> -20,000 gallon Xerxes double-walled fiberglass tank <br /> -12,000 gallon/8,000 gallon Xerxes double-walled fiberglass split tank <br /> -Verified UL labeling on all tanks. <br /> -Inspected tanks for brine leaks. No leaks observed on the split tank. <br /> -Inside of split tank was inspected by the contractor on site and stated to be clean and brine-free. <br /> -Verified the use of the manufacturer installation checklist at the time of inspection. <br /> -Verified presence of deadmen and use of anchor straps. <br /> -Verified use of proper pea gravel backfill and witnessed initial backfilling with pea gravel. <br /> -Verified the application of additional corrosion protection on all metal anchor components. <br /> *-Primary Tank test according to manufacturer specification scheduled 03/09/2022. <br /> **Additional inspections are required. Refer to the approval letter dated February 23, 2022 for a list of inspections <br /> needed.**During inspection it was noted that the new UST brought to the site was labeled as 12,000/10,000 gallons, and not <br /> the 12,000/8,000 which was approved in the EHD's SR0083066 permit application. In response to the concerns raised by the <br /> EHD, a letter signed by Stefan Thorsteinson of Xerxes(dated 3/4/2022)was provided,which indicated that"Xerxes regrets <br /> any misinformation provided and advise that the capacity of the end tank is 8,000 US gallons and NOT 10,000 US gallons as <br /> labeled". The tank serial number 91004500 referenced in the aforementioned Xerxes letter, matches the serial number on the <br /> tank's shipping paper and matches the tank's label.The onsite contractor measured the received tank, and physicals tank <br /> dimensions match the cut sheets of the 12,000/8,000 gallon UST submitted with the installation permit. <br /> Please be advised that if it becomes evident that the installed tank deviates from the approved installation plans,this tank <br /> installation will become un permitted. <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 mailed Report to:Valburg, Ethan, E <br /> EH Specialist: PAUL NSO Phone: (209)616-3049 <br /> SR0083066 SC131 03/04/2022 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />