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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: 08/28/2023 <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;VMI, 03/10/24; OPW, 02/24/24 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections: <br /> -Witnessed first monitoring system functionality testing after fuel delivery-Passed <br /> -Leak detector test- Passed <br /> Needed for final approval <br /> -Provide compatibility for all monitoring system components(tank, piping, containment sumps, pumping equipment, release <br /> detection equipment, overfill prevention equipment)with the substance stored (renewable Biodiesel 20).Your application for a <br /> permit to operate stated diesel and NOT renewable Biodiesl 20. <br /> -And all outstanding up to date permit fees must be paid prior to receiving the final approval to operate <br /> Refer to the approval letter dated 08/1/2022. <br /> This facility is not approve to operate the UST system at this time. <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 to: Chevron, Permit Se <br /> EH Specialist: PAUL NSO Phone: (209)616-3049 <br /> SR0084544 SC298 08/28/2023 <br /> EHD 23-01 Rev.07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />