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Time In: <br />Time Out: <br />p P.QUtN. p San Joaquin County <br />z. .z Environmental Health Department <br />Q: <br />1868 East Hazelton Avenue, Stockton, CA95205-6232 <br />Q. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siQov.org/ehd <br />Li F oaf. <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: i ESORO/SHELL 68 15: <br />Date: X6/10/201,. <br />Address: 2448 W KETTLEMAN LN, LODI 95240 <br />Requestor: <br />Telephone: <br />Program Element: 2308 - UST RETROFIT <br />Request #: '?O074954 <br />Inspection Type: ._•09 _ I IcT pr-:TPr�r= T prnr,io If, <br />Onsite Service Technician lawiclo ivllranua <br />ICC Service Tech'Installer Exp. Date: 2j29/2017 <br />Manufacturer training: Franklin Fueling, 01/22/18 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />Un site to witness the one hour lake test of the vapor and fill spill containers of the 87 and 91 tanks. <br />Verified that these spill containers hold a minimum of five gallons. <br />All pass. <br />Facility may receive fuel. <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 />y ` x <br />Received by: ` ,\,, 1� 1�•a Name and Title: �,:� ►, `���`�\r\�' <br />EH Specialist: ARIS VELOSO <br />Phone: (209) 468-3453 <br />FA0000505 SR0074954 SC298 06/10/2016 <br />EHD 23-01 Rev. 06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />