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SAN <br /> J O A U I Environmental Health Department <br /> COUNTY <br /> Grrarness grows hare, <br /> Service Request Inspection Report <br /> Name of Facility: TRIANGLE PLAZA TRACY Date: 12/17/2024 <br /> Address: 3788 N TRACY BLVD , TRACY 95304 <br /> Requestor: SARAH JABLONSKY,WALTON ENGINEERING, INC Telephone: (916)373-1165 <br /> Program Element: 2303- UST/PIPING INSTALLATION Request#: SR0087879 <br /> Inspection Type: 131 -UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Juan Delgado ICC Service Tech/Installer Exp. Date: 07/22/2026 <br /> Manufacturer training: Xerxes, 01/17/25 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site install inspection: <br /> -Witnessed tank set for 24,000-gallon/6,000-gallon split tank and 15,000-gallon/15,000-gallon split tank <br /> -Verified UL labels on tank. UL number is G-38702066 on the 15k/15k split. UL number is G-38702107 on the 24k/6k split. UL <br /> listing label is found in the tank sump. G#is printed on ends of tanks <br /> -No leakage of brine observed or noted by installers <br /> -Observed tank installation checklists on site <br /> -Witnessed anchor straps installed and corrosion protection added to metal exposure on both tanks <br /> -Observed proper backfill on site <br /> -Witnessed start of backfill <br /> Please ensure as-built drawings show the correct orientation of the 15k/15k split tank. Base is facing I-205, End is facing W <br /> Larch. <br /> Facility is not approved to receive fuel in the UST system. Facility is not approved to operate UST system. <br /> Additional inspections are required. Please see approval letter dated December 13, 2024 for additional inspections. Please <br /> submit all inspection requests in writing to UST@sjgov.org <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. <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 Richard Walton, Installer <br /> EH Specialist: CAROL PRESTO Phone: (209)616-3061 <br /> SR0087879 SC131 12/17/2024 <br /> EHD Rev.09/16/2020 Page 1 of 1 Service Request Inspection Report <br />