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i <br /> i <br /> Time In: <br /> Time Out <br /> Satn Jdaquin County ) L' <br /> Environmental Health Department <br /> 1668 East Hazelton Avenue, Stockton, CA95205-6232 I <br /> Telephone.(209)468.3420 Fa. (209)464-0138 web.www-sigov.om/ehd <br /> Un erground Storage Tank Program Service Request inspection Report j <br /> Name of Facility: CRUISERS MANTECA#29 Date: 08/2212017 <br /> Address: 1137 W LATHROP RD,MANTECA 95336 <br /> i <br /> itequestor: NICHOLAS ROWE, L C SERVICES LARRY&CLIFF ENTERPRISES INC Telephone: (559)444-1734 <br /> Program Element 2308-UST RETROFIT Request#: SR00766BO " <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician Mark Steinhauer ICC Service TecNInsta(ter Exp. Date: 0310312019 <br /> i <br /> i <br /> Manufacturer training: Veeder Root,06/29/18AM 1 I <br /> i MAW, <br /> ( •..r r <br /> JQJE.`L <br /> , <br /> On site to verify replaced epoxy,brine communication and functionality of the sump and brine sensors In the diesel fill sump. <br /> All sensors were functional and communication of brine was verified. <br /> i <br /> Facility Is authorized to operate. " <br /> 1 <br /> I <br /> r <br /> 1 <br /> i <br /> I <br /> 1 <br /> 1 <br /> l <br /> 1 <br /> I <br /> 1 <br /> , <br /> 'i <br /> 3 <br /> , <br /> l <br /> i <br /> i <br /> i <br /> The person in charge is responsible for ensuring that the above mentioned faclilty Is in compliance with all applicable Sections of the California Health and <br /> Sr,fety Code.It a Wnspactlon Is required,fees will be assessed at the current hourly rate. <br /> f <br /> Received by: Name and Title: Mark Steinhauer,Service Technician <br /> E-i Specialist: CESAR RUVALCABA Phone: (209)953-6213 <br /> " <br /> FA0019793 SR0076680 S0298 051=01, ' <br /> 1 <br /> D10 23-01 Rey.08190/16 Page 1 of 1 Underground Storage Tank Program Service Request Inspect on Repor <br /> L � <br /> I <br />