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Time In: <br />Time Out: <br />911 r4.. San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />• c . P • Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orQ/ehd <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: CHEVRON STATION #307709" <br />Date: 03/20/2018 <br />Address: 10858 TRINITY PKWY, STOCKTON 95219 <br />Requestor: GLENN KELLEY, WAYNE PERRY INC. <br />Telephone: (916) 646-9680 <br />Program Element: 2308 - UST RETROFIT <br />Request #: SR0078748 <br />Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br />Onsite Service Technician: Jarrod Cooke <br />ICC Service Tech/Installer Exp. Date: 04/16/2019 <br />Manufacturer training: Veeder Root, 05/09/18; VMI, 02/24/19 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site to witness the following inspections: <br />-Verify functionality of the monitoring system. <br />-Observe leak detector tests for tanks TA0515796, TA0515797 and TA0515798. <br />All passed. <br />Facility is approved to operate and receive fuel. <br />Note: report was mailed to Permit Desk <Perm itDesk@chevron. com> and mailed to the tank operator. <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: <br />Name and Title: <br />EH Specialist: JOHN ALANIZ Phone: (209) 468-3147 <br />FA0017737 SR0078748 SC298 03/20/2018 <br />EHD 23-01 Rev. 06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />