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Time In <br /> Time Out: <br /> San Joaquin County <br /> z z Environmental Health Department <br /> " 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> a+ / awYrY Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www sioov ora/ehd <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: VALLEY PACIFIC LODI PLANT & CARDLOCK Date: 03/23/2015 <br /> Address: E VICTOR RD, LODI 95240 <br /> Requester: -'KE ELLASON,VALLEY PACIFIC PETROLEUM SERVIC- Telephone (209) 993-8793 <br /> Program Element: 2308- UST RETROFIT IRequestt. SR0074101 <br /> Inspection Type: 298-UST RETROFIT r_-^AIR INSPECTION <br /> Onsite Service Technician Richard The ICC Service TecHlnstaller Exp. Date: 12105' <br /> Manufacturer training Veeder Root,12 VMI, 12/30/16: SWRCB,06/30/18 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness the 3 gallon per hour at 10 psi leak detector test. <br /> The VMI 99LD2000leak detector serial number1502137 for the north 87 tank passed. <br /> Remember to complete the following: <br /> Secondary containment testing on the repaired 87 product secondary piping is required six months after installation. Provide <br /> 48 hours notification to the EHD when this test is scheduled. <br /> Log into the California Environmental Reporting System(CERS), update as necessary and submit the"UST Monitoring Plan' <br /> for the 87 tank for approval. <br /> Log into the California Environmental Reporting System(CERS), complete and submit a"UST Certification of <br /> installation/Modification"form for the repaired 87 product secondary containment pipe within 30 days. <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 remssp/e/cftion is required,fees will be assessed at the current hourly rate. / ��// <br /> Received by: ' ` Name and Title: . {u4ke tQ& 1,'fl n , Co ypocC /`"cµC7 9,4p— <br /> EH Specialist: 3 VE Phone: (209)468-3453 <br /> FA0005584 SR0074101 SC298 03232016 <br /> EHD 2301 Rev.GG30115 Page 1 of 1 underground Storage Tank Program Service Request Inspeam Report <br />