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°• Environmental Health Department <br /> �. �J r� SHAWN <br /> t 7Y - L. <br /> Y <br /> ttlir- ' COUNTY— <br /> Greol less grows he: . . <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: CHEVRON Date: 08/08/2023 <br /> Address: 1222 W ATHERTON DR , MANTECA 95337 <br /> Requestor: CHEVRON LICENSE&PERMITS SPECIALIST, CHEVRON Telephone: (925)842-9002 <br /> Program Element: 2303-UST/PIPING INSTALLATION Request#: SR0084544 <br /> Inspection Type: 298-UST SERVICE REQUEST- FIELD ACTIVITY <br /> Onsite Service Technician: Landon Zamora ICC Service Tech/Installer Exp. Date: 05/24/2025 <br /> Manufacturer training: VR, 04/04/25; OPW, 02/24/24 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections before fuel delivery. <br /> - Verified communication (vacuum )in UDCs,vent,fill and STP sumps and at end point of each vacuum zones <br /> - Verified diesel tank spill container 5 gallon capacity and drainage <br /> - Witnessed diesel tank spill container test. <br /> - Verified diesel tank drop tube flappers functionality. <br /> - Verified all smart sensors functionality. <br /> All passed.To minimize person to person contact EHD is choosing to write the name of person receiving the report instead of <br /> having them sign. <br /> This facility is approve to receive fuel. <br /> —Additional inspections are required after fuel delivery . Refer to the approval letter dated August 1, 2022 for a list of <br /> inspections needed. <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 mail report chevron Permit, License <br /> EH Specialist: PAUL NSO Phone: (209)616-3049 <br /> SR0084544 SC298 08/08/2023 <br /> EHD 23-01 Rev.07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />