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SAN JOAOUI Environmental Health Department <br /> C U NTY Time In: <br /> Time Out: <br /> ' SS grows hoj— <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: CHEVRON Date: 05/21/2020 <br /> Address: 1231 N MAIN ST , MANTECA 95336 <br /> Requestor: GLENN PAREDES, B&T SERVICE STATION CONTRACTORS Telephone: (916) 984-1537 <br /> Program Element: 2303- UST/PIPING INSTALLATION Request#: SR0077446 <br /> Inspection Type: 131 - UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Shawn Byham ICC Service Tech/Installer Exp. Date: 05/07/2021 <br /> Manufacturer training: VR, 06/24/21; VMI, 05/15/22; OPW,07/20/20 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspection: <br /> -Witnessed monitoring system functionality, after first fuel delivey in operation condition, verified functionality and <br /> communication of hydrostatic, liquid sensors in tanks, sumps and under dispenser containment,- passed <br /> -Witnessed Spill container testing, Verified 5-gallon capacity and one hour hydrostatics test, and proper drainage - passed <br /> -Witnessed leak detector test to detect a leak of 3gallons per hour at 10psi- passed <br /> -verified VPH components shroud boots for spill containers, band clamps, and rubber gaskets. <br /> -Assisted in CERS set up <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead of having them <br /> sign. <br /> ****Additional requirements. Refer to the approval letter dated December 12, 2018 for a list of documentation needed. <br /> *This facility is not approve to operate the UST system at this time. All outstanding up to date permit fees must be paid prior <br /> toreceiving the final approval to operate. <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: Aaron Straw, Service Tech <br /> EH Specialist: PAUL NSO Phone: (209)468-3432 <br /> SR0077446 SC131 05/21/2020 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />