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Time In: <br /> Time Out: <br /> C4, <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 web:www.siaov.orcVehA�`P <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: "i N ^G SAN imp V EL. MARKET' Date. <br /> Address: 0 S Cherokee LN , LODI 95240 <br /> Requestor: Telephone (408)938-7103 <br /> Program Element 2308- UST RETROFIT Request#: SR0074031 <br /> Inspection Type: 298- UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician Kristopher Bell ICC Service TechInstaller Exp. Date: 016 <br /> Manufacturer training: Veeder Root,03/04/16 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness the functionality test of the monitoring system post"Cold Start'. <br /> Sensor functionality and the audible visual alarm at900/b for overfill prevention were verified. <br /> All pass. <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: r <br /> EH Specialist: ARIS VELOSO c Phone: (209)468-34.53 <br /> Cow, IQV1C� Q r � 'S% FAD014852 SR0074031 SC298 02/052016 <br /> 4¢HD 23-0 ev.08130!15 Page 1 of 1 Undefgnwnd Storage Tank Pmgmm Service Request Inspection Report <br />