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Time In: <br /> Time Out: <br /> ���H San Joaquin County <br /> 1 c°' <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> Underground Storage Tank Program Service Request inspection Report <br /> Name of Facility: COUNTRY MARKETPLACE Date: 03/24/2016 <br /> Address: 1789 W CHARTER WAY, STOCKTON 95206 <br /> Requestor: EMILY CRAIN, BZ MAINTENANCE Telephone: (916) 371-2380 <br /> Program Element: 2308-UST RETROFIT Request#: SR0074414 <br /> Inspection Type: 298- UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician Rhome Desbiens ICC Service Tech/Installer Exp. Date: 01/28/2017 <br /> Manufacturer training: VMI Tester,02/09/17 <br /> OVERALL. INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> Witnessed functionality testing of the 87 leak detector after replacement, at 3 gph at 10 psi. Failed. The leak detector was <br /> adjusted and retested. Passed. <br /> VMI 99LD2000-Serial number 16011329 <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: Rhome Desbiens, Technician <br /> EH Specialist: STACY RIVERA Phone (209) 468-3440 ^ <br /> FA0007486 SR0074414 SC298 03/24/2016 <br /> EHE 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />