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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> Donna K.Heran,R.E.H.S. Unit Supervisors <br /> N: 304 East Weber Avenue, Third Floor Carl Borgrnan,R.E.H.S. <br /> Director <br /> '• AI Olsen,R.E.H.S. Stockton, California 95202-2708 Mike Huggins,R.E.H.S.,R.D.I. <br /> oq <br /> Douglas W.Wilson,R.E.H.S.Program Manager Man ax: ( <br /> Telephone: (209)468-3420 Margaret Lagorio,R.E.H.S. <br /> Laurie A.Co R.E.H.S. F209) 464-0138 Robert McClellon,R.E.H.S. <br /> Program Manager Mark Barcellos,R.E.H.S. <br /> September 18, 2003 <br /> Fillner Construction Inc., <br /> Attn: Michael Carruth and Jeff Scott Q <br /> 3633 Seaport Blvd. <br /> W. Sacramento, CA 95691 <br /> r��vv <br /> Fax: (916) 372-0911 - <br /> RE: 1987 W. 11th Street–Safeway#2600–SR0035273 <br /> Your permit application to remove and replace an existing underground storage piping at the above <br /> referenced location has been approved with the following conditions: <br /> Removal Conditions: <br /> 1. Contact the local fire department for permit requirements. <br /> 2. Samples must be taken and analyzed by a State certified Laboratory for the analysis as stated on <br /> pages 4 and 5 of the permit application. All analytical results must come from a California certified <br /> laboratory within 30 days of removal date or this office will not accept them. <br /> 3. EHD must witness the soil sampling and piping removal. Contact EHD to arrange this inspection <br /> appointment. <br /> 4. The nearby storm drains shall be protected from any possible contamination. <br /> Installation Conditions: <br /> 1. Contact the local fire department and San Joaquin Valley Air Pollution Control District for applicable <br /> permits. <br /> 2. Any changes in information or scope of work must be submitted to EHD prior to commencing work. <br /> 3. All piping and connections shall bear an UL label. <br /> 4. Contact EHD for the following inspections: <br /> a. Sampling. <br /> b. Primary piping and Secondary piping. <br /> c. 24-hour lake test on under dispenser pans that are subjected to this project. <br /> d. Final inspection: <br /> i. A final inspection must be performed prior to returning this station to-neration. <br /> ii. A third party certified piping line tightness test must be performed and provide results <br /> prior to scheduling the final inspection. - <br /> iii. A third party certified Secondary Containment Test must be performed and provide <br /> results priors to scheduling the final inspection. 7,3 <br /> iv. Submit a"Certificate of Compliance for Underground Storage Tank Form C" prior to <br /> scheduling the final inspection. A blank form is provided. <br /> �v Submit an As-Built plan to EHD at the time of the final inspection. Note: A final <br /> inspection will not be performed unless the as-builts are submitted. <br /> Safeway#2600—1987 W. 110'Street,Tracy,CA Page 1 of 2 <br />