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. Time In: <br /> Time Out: <br /> San Joaquin County <br /> Environmental Health Department <br /> W. :< <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> •�f�i i�dYt�'�? <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.siaov.org/ehd <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: KAISER FOUNDATION-MANTECA Date: 12/06/2018 <br /> Address: 1777 W YOSEMITE AVE , MANTECA 95337 <br /> Requestor: MIKE ELLIS, BELSHIRE ENVIRONMENTAL SERVICES, INC Telephone: (951)675-7233 <br /> Program Element: 2308-UST RETROFIT Request#: SR0079834 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Saul Gonzalez ICC Service Tech/Installer Exp. Date: 09/23/2019 <br /> Manufacturer training: Bravo, 02/20/20; INCON, 03/16/20 <br /> .a. <br /> °° OVER/fLL,INSPECTION NEESAND,COMMENTS <br /> NOTES <br /> On site to witness secondary containment testing in the Diesel piping sump.The service technician conducted a 24 hour <br /> hydrostatic equivalent testing using the INCON system with a leak rater of 0.002 for 15 minutes.Test passed. <br /> Be aware that secondary containment testing for the Diesel piping sump is required six months after the the installation of the <br /> penetration fittings.The secondary containment retest is due by June 2019. Provide 48 hour notification to EHD when this test <br /> is scheduled. <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: Saul Gonzalez, Service Technician <br /> EH Specialist: ZUNA BARKER Phone: (209) 953-7311 <br /> FA0003978 SR0079834 SC298 12/06/2018 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />