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ur I Environmental Health Department <br /> 41 t: SAN-6-JOAQU <br /> vii fir : C(--)LJ Y Time In: <br /> r <br /> Time Out: <br /> r'�JFOSX:, Careotness grows here. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: MY MINI MART Date: 08/14/2020 <br /> Address: 1756 N WILSON WAY, STOCKTON 95205 <br /> Requestor: MEGAN MITCHELL, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2308-UST RETROFIT Request#: SR0082302 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Chris Adams ICC Service Tech/Installer Exp. Date: 09/01/2020 <br /> Manufacturer training: VeederRoot, 10/08/21 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On-site for the following: <br /> -Verified sensor functionality after replacement of monitoring panel and sensors to VeederRoot TLS-350. <br /> -A copy of alarm history prior to removal of Incon system was not available at the time of inspection. Per service technician, <br /> Incon panel no longer had the functionality to print alarm histories. <br /> This facility is approved to operate. <br /> To minimize person to person contact EHD is choosing to write the name of the person receiving the report instead of having <br /> them sign. <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: Chris Adams, Service Technician <br /> EH Specialist: STACY RIVERA Phone: (209)468-3440 <br /> FA0001858 SR0082302 SC298 08/14/2020 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />