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Time In: <br /> Time Out: <br /> �P.�•ut�!. c San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> • c... :P• Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> ���FORN <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: SJ CO PUBLIC WORKS CORP YARD* Date: 04/11/2019 <br /> Address: 1810 E HAZELTON AVE, STOCKTON 95205 <br /> Requestor: JOSEPH BAGLEY, BAGLEY ENTERPRISES, INC. Telephone: (209) 367-4800 <br /> Program Element: 2308- UST RETROFIT Request#: SR0080222 <br /> Inspection Type: 298- UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Eric Molgaard ICC Service Tech/Installer Exp. Date: 02/22/2021 <br /> Manufacturer training: OPW,02/27/21 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following: <br /> -Witnessed diesel overfill flapper functionality. <br /> -Verified diesel overfill flapper measurements and calculations at a maximum of 95% tank capacity. <br /> -Diesel spill bucket and 87 leak detector testing are being conducted by Ed Stearns and will not be witnessed by EHD. <br /> ICC Service Technician: 11/9/2020 <br /> Tank Tester: 9/30/2020 <br /> SB: 11/29/2020 <br /> VMI: 6/20/2019 <br /> **Once passing test results have been obtained for the diesel spill bucket(1 hour hydrostatic, 5 gallon capacity, drainage) and <br /> the 87 leak detector, this facility is approved 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: Eric Molgaard, Technician <br /> EH Specialist: STACY RIVERA Phone: (209)468-3440 <br /> FA0003954 SR0080222 SC298 04/11/2019 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />