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SAN JOAQUIN <br />U IN i y <br />. Gre�trless grows he, . . <br />Environmental Health Department <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: MOUNTAIN HOUSE CHEVRON <br />Date: 08/19/2022 <br />Address: 1124 INTERNATIONAL PKWY, TRACY 95377 <br />Requestor: MR MUTHANA IBRAHIM, M I ARCHITECTS, INC. <br />Telephone: (925) 287-1174 <br />Program Element: 2303 - UST/PIPING INSTALLATION <br />Request #: SR0084001 <br />Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br />Onsite Service Technician: Latham Zubillaga <br />ICC Service Tech/Installer Exp. Date: 01/05/2024 <br />Manufacturer training: XERXES, 03/04/23 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for the for 87, 91 and diesel tanks testing inspection. <br />-Witnessed tanks testing: One pneumatic pressure test at 5psi of 87, 91 and diesel tanks. <br />-Soap test all bolts- no bubbles. <br />All passed <br />This facility is not approve to operate the UST system. Additional inspection required see approval letter dated 2/4/2022. <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: <br />EH Specialist: PAUL NSO <br />Name and Title: E mail report to:Latham Zubillaga, Co <br />Phone: (209) 616-3049 <br />SR0084001 SC298 08/19/2022 <br />EHD 23-01 Rev. 07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />