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Time In: <br /> Time Out: <br /> aR419J. San Joaquin County <br /> Environmental Health Department <br /> W. X <br /> 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> a4rj.•aR�;`� <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: Country Club Valero Date: 01/16/2018 <br /> Address: 2575 COUNTRY CLUB BLVD, STOCKTON 95204 <br /> Requestor: MARK VENDEIRO, M V P PETROLEUM ENGINEER INC Telephone. (916) 984-1537 <br /> Program Element: 2308- UST RETROFIT Request#: SR0076812 <br /> Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Steve Jones ICC Service Techllnstaller Exp. Date: 07/05/2019 <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections: <br /> -Visual verification of the brine level in the 87 fill sump. OK. <br /> -Verification of brine communication in the 87 fill sump annular. OK <br /> All inspections for this service request have been completed. <br /> *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: Steve Jones, Technician <br /> EH Specialist: STACY RIVERA Phone: (209)468-3440 <br /> FA0006439 SR0076812 SC298 01/16/2018 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />