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Time In: <br /> Time Out: <br /> o�A"Ih San Joaquin County <br /> >r, Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> .p Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.siaov.om/ehd <br /> UFpAN� <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: 7-ELEVEN INC#17334 Date: 10/13/2017 <br /> Address: 4501 N PERSHING AVE, STOCKTON 95207 <br /> Requestor: MICHAEL WALTON,WALTON ENGINEERING INC Telephone: (916)373-1165 <br /> Program Element: 2308-UST RETROFIT Request#: SR0078234 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Jesse Andrade ICC Service Tech/Installer Exp. Date: 02/08/2018 <br /> Manufacturer training: Installer,09/09/18; OPW, 12/31/18 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> Onsite to witness secondary containment test on the 91-octane annular,verified 5-gallon capacity of the 91-octane spill <br /> container, one hour hydrostatic test,and drain valve.All tests passed. <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: Ila- Name and Title: Jessie Andrade Tech <br /> EH Specialist: AARON HANG Phone: (209)468-3453 <br /> FAOOW479 SRW782M SC2% 1011W017 <br /> EHo 23-01 Rev.08/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />