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SANJOANIN Environmental Health Department <br /> C O U N T Y Time In: <br /> Time Out: <br /> r'eatAess 9rpv,-. )1 c,-!- <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: TRACY SHELL* Date: 10/27/2020 <br /> Address: 3725 N TRACY BLVD, TRACY 95376 <br /> Requestor: SCOTT WILLETT, DIMAGGIO MAINTENANCE INC Telephone: (760) 722-9002 <br /> Program Element: 2308- UST RETROFIT Request#: SR0082288 <br /> Inspection Type: 298- UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Raul Ortege ICC Service Tech/Installer Exp. Date: <br /> Manufacturer training: ICC Inst., 08/10/21; Bravo, 12/18/20 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> One site for the following inspection: <br /> -Verified dispensers footprint contained by the under dispenser containment sumps(UDCs), fuel filters drain directly into <br /> UDCs. <br /> -Verified piping within the dispensers, no evidence of any leaks <br /> -Verified Installation of Bravo Conversion frames. <br /> *This facility is approve to operate the UST system. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead of having them <br /> sign. <br /> *Amend scope of work to reflect work actually completed. <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: Raul Ortege, Service Tech. <br /> EH Specialist: PAUL NSO Phone: (209) 616-3049 <br /> FA0003780 SR0082288 SC298 10/27/2020 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />