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Time In: <br /> Time Out: <br /> ha�lN San Joaquin County <br /> Environmental Health Department <br /> W. X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • ... Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.orglehd <br /> 4�IFpRa� <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: COUNTRY MARKETPLACE Date: 02/26/2018 <br /> Address: 1789 W CHARTER WAY, STOCKTON 95206 <br /> Requestor: FRANZEN HILL, FRANZEN-HILL CORP Telephone: (559)688-1467 <br /> Program Element: 2308-UST RETROFIT Request#: SR0078652 <br /> Inspection Type: 005-INSPECTION 1 SERVICE(Chargeable) <br /> Onsite Service Technician: Zane Nimmo ICC Service Techlinstaller Exp. Date: 06/02/2019 <br /> Manufacturer training: Tank Tester,03131119; Petro-tite,02/16/20 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness a 0.1 gallon per hour test by a licensed SWRCB Tank Tester conducted on the 87 and 91 octane primary <br /> piping. Both line passed.Verify one hour pressure test for 91 and 87 octane secondary piping at dispenser 516 and 9110 per <br /> manufacturer's guidelines after backfill and concrete was poured.Test passed. <br /> Also on site to witness a containment sump integrity testing on under dispenser containment(UDC)sumps 516 and 9110 after <br /> backfill and concrete was poured. Service technician Alex Puentes(expiration date 3122119)and Sump Test System <br /> Operation-INCON level 4(expirartion date 118120)conducted the test.Test on UCD 516 and UDC 9110 passed. <br /> After passing results the facility in now allowed to operate UDC 112, UDC 516, and UDC 9110 only. <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 Cade.If a reinspection is required,fees will be assessed at the current hourly rate. <br /> Received by: Name and Title: Alex Puentes, Project Manager <br /> EH Specialist: ZUNA BARKER Phone: X209 9) 53-7311 <br /> FA0007486 SR0078552 SCO05 02/2612018 <br /> EH❑23-61 Rev.06130115 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />