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Time In <br />Time Out: <br />oP4�l�r. San Joaquin County <br />2' y Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />��FOR <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: H&M - BW #98 <br />Date: 03/17/2016 <br />Address: 2501 JACKSON AVE, ESCALON 95320 <br />Requestor: CLIFF WOODS, L C SERVICES LARRY & CLIFF ENTERPRISES INC <br />Telephone: <br />(559) 444-1730 <br />Program Element: 2308 - UST RETROFIT <br />Request #: <br />SR0073493 <br />Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br />Onsite Service Technician Gabriel Venegas <br />ICC Service Tech/Installer Exp. Date: <br />07/22/2017 <br />Manufacturer training: Veeder-Root, 03/01/18 <br />NOTES <br />Witnessed functionality testing of the monitoring system, after a cold start of the monitoring panel, including sensor out and fail <br />safe. All passed. <br />An alarm history was provided for before the cold start, which included the following alarms: <br />L1 (UNL STP) Oct 8, 2015 Setup data warning <br />L2 (UNL ANN) Oct 8, 2015 Setup data warning <br />L3 (PREM STP) Oct 8, 2015 Setup data warning <br />L4 (DIESEL STP) Mar 5, 2016 Fuel alarm <br />Dec 22, 2015 Setup data warning <br />Dec 22, 2015 Fuel alarm <br />L5 (PREM -DSL ANN) Oct 8, 2015 Setup data warning <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 />�//V <br />Received by: <br />EH Specialist: STACY RIVERA <br />Name and Title: Gabriel Venegas, Technician <br />Phone: (209) 468-3440 <br />FA0003910 SR0073493 SC298 03/17/2016 <br />EHD 23-01 Rev. 06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />