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S A N J Q Q Q U IN Environmental Health Department <br /> COUNTY <br /> Greorness grows here. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: STOP N SHOP Date: 02/22/2023 <br /> Address: 1856 W COUNTRY CLUB BLVD , STOCKTON 95204 <br /> Requestor: CARRIE MILLER, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2308-UST RETROFIT Request#: SR0086254 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Benjamin Malaspina ICC Service Tech/Installer Exp. Date: 06/17/2024 <br /> Manufacturer training: BRAVO, 06/17/25 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following: <br /> -Verified dispenser footprints contained by the under dispenser containment(UDC). <br /> -Visual inspection of the piping within the dispensers. <br /> To minimize person to person contact EHD is choosing to write the name of the person receiving the report instead of having <br /> them 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: Emailed to Carrie Miller, Contractor <br /> EH Specialist: GABRIELA GARCIA-MEJIA Phone: (209)616-3037 <br /> FA0001909 SR0086254 SC298 02/22/2023 <br /> EHD 23-01 Rev.07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />