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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: WILSON CHEVRON Date: 11/22/2023 <br /> Address: 4343 N WILSON WAY, STOCKTON 95205 <br /> Requestor: GURPARTAP SINGH,WILSON CHEVRON Telephone: (925)724-8010 <br /> Program Element: 2303-UST/PIPING INSTALLATION Request#: SR0086245 <br /> Inspection Type: 298-UST SERVICE REQUEST- FIELD ACTIVITY <br /> Onsite Service Technician: Latham Zubillaga ICC Service Tech/Installer Exp. Date: 01/05/2024 <br /> Manufacturer training: NOV, 12/24/23;Xerxes, 03/22/26; Bravo, 01/06/26 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> Witnessed: <br /> -Auto side secondary piping soap test and hour pressure test on product,vent, chase and vapor recovery. Held 1 hour. <br /> -Auto side slope at 1/8 inch or greater on all piping <br /> -Appropriate auto side piping setbacks, cross-overs and burial depth <br /> -Auto side integrity testing of fill and STP sumps(UDCs and vent sump were tested 11/16/2023) <br /> -Auto side UDC brine addition <br /> Please provide: <br /> -Bravo certification for Kevin Ceja <br /> -Documentation showing styrofoam pipe holders can be left in place when backfilling with pea gravel <br /> Additional inspections are required. Please refer to approval letter dated June 19, 2023, section 6 and inspection sign-off sheet <br /> for required inspections. Ensure 48-hour advanced written notice is submitted to UST@sjgov.org <br /> Facility is not approved to receive fuel in the tanks or operate the UST system. <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 /> Note: <br /> -The original inspection sign-off sheet was taken today and replaced with two sign-off sheets. One blue sheet for truck side <br /> inspections and one green sheet for auto side inspections. Please ensure to keep both for inspections. <br /> -The auto side fill and STP sumps brine filling was not witnessed today <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: Latham Zubillaga, latham@tccontrac <br /> EH Specialist: CAROL PRESTO Phone: (209)616-3061 <br /> SR0086245 SC298 11/22/2023 <br /> EHD 23-01 Rev.07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />