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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: ELEVEN INC.#32190 Date: 6/23/2025 <br /> Address: 4943 S. State Rt. 99, Stockton, CA 95215 <br /> Requestor: Christina Tran Telephone: <br /> Program Element: 2308- UST RETROFIT Request#: SR2500901 <br /> Inspection Type: 4320- UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Eusebio Sousa ICC Service Tech/Installer Exp. Date: 6/9/2027 <br /> Manufacturer training: INCON; 5/9/2026 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> - Inspection for repair penetration boots in all piping sumps,fill sumps, and UCDs <br /> -Witness the start of the integrity testing of the UDC 1/2, 3/4, and 7/8. <br /> -Verified penetration boots in fill sumps, piping sumps <br /> -*** Note: Liquid was observed inside the UDCs at the time of inspection prepared for the integrity test. <br /> -Additional inspections are required. Please see approval letter dated April 15, 2025 for a list of requirements. Submit inspection <br /> requires in writing to UST@sjgov.org with 48-hours advanced notice. <br /> -To minimize person to person contact EHD is choosing to write the name of the person receiving the report instead of having them 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 Christina Tran, Contractor <br /> EH Specialist: KRISTINA SAETERN Phone: (209)616-3045 <br /> FA0014623 SR2400414 SC4320 11/21/2024 <br /> EHD Rev.09/16/2020 Page 1 of 1 Service Request Inspection Report <br />