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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: SPEEDWAY#4873 Date: 10/19/2023 <br /> Address: 35 N CHEROKEE LN , LODI 95240 <br /> Requestor: SARAH JABLONSKY-CONSTRUCTION MANAGER,WALTON ENGINEER Telephone: (916)373-1165 <br /> Program Element: 2308-UST RETROFIT Request#: SR0087243 <br /> Inspection Type: 001 -ROUTINE INSPECTION-Operating Permit <br /> Onsite Service Technician: Thomas Sanford ICC Service Tech/Installer Exp. Date: 07/10/2025 <br /> Manufacturer training: BRAVO, 11/19/24; FFS Flex Connector, 04/16/24; NOV, 01/27/26 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following: <br /> -Verified primary piping soap test on the 87 product piping. Passed. <br /> -Verified secondary piping test for the boot. Passed. <br /> -Verified secondary piping slope at 1/8 inch per foot. <br /> -Verified pipe setbacks, cross-overs, and burial depth. <br /> This facility is not approved to operate. <br /> See the approval letter with date of October 5, 2023 for more inspections. <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. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate($162). To schedule an <br /> appointment, please call (209)468-3420. <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 Sarah J, Contractor <br /> EH Specialist: KRISTINA SAETERN Phone: (209)616-3045 <br /> FA0003602 SR0087243 SCO01 10/19/2023 <br /> EHD 23-01 Rev.07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />