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SANJI Environmental Health Department <br /> COU NTY Time In: <br /> Time Out: <br /> rrrws Ter!. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: PACIFIC CAR WASH MARKETPLACE INC Date: 07/15/2020 <br /> Address: 4405 PACIFIC AVE, STOCKTON 95207 <br /> Requestor: Telephone: (916) 373-1165 <br /> Program Element: 2302 - UST TEMPORARY CLOSURE Request#: SR0082286 <br /> Inspection Type: 292 - UST TEMP CLOSURE INSPECTION <br /> Onsite Service Technician: Rafael E Flores ICC Service Tech/Installer Exp. Date: 02/14/2021 <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the temporary closure of 87 and 91 gasoline (split)tank. <br /> -Verified removal of residual liquid, and sludge using licensed hazardous waste hauler and disposal <br /> -Witnessed decontamination and inert of tanks with 600 pounds of dry ice <br /> -Witnessed sealing of all fill and piping locations <br /> -Verified disconnection of power service from all pumps and Veeder Root <br /> LeL o% <br /> oxygen 20.9% <br /> This facility cannot receive fuel in the 87 and 91 tanks prior to EHD inspection and approval. <br /> * Note that quarterly inspections are required and EHD must be on site to witness all quarterly inspections. <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: Richard S. Walton, Project Manager <br /> EH Specialist: PAUL NSO Phone: (209)468-3432 <br /> FA0007787 SR0082286 SC292 07/15/2020 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />