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Time In: <br />Time Out: <br />�P.�•ut�!. c San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA95205-6232 <br />• c ... :P • Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />���FORN <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: UNITED # 5447 <br />Date: 03/05/2019 <br />Address: 1469 E HAMMER LN, STOCKTON 95210 <br />Requestor: MATT THOMAS, CGRS INC <br />Telephone: (626) 627-8316 <br />Program Element: 2308 - UST RETROFIT <br />Request #: SR0079662 <br />Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br />Onsite Service Technician: Leonardo Rangel <br />ICC Service Tech/Installer Exp. Date: 07/22/2019 <br />Manufacturer training: OPW, 03/14/20 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />Witnessed one hour hydrostatic testing of the 91 direct -bury spill bucket. Passed. <br />Verified 5 gallon capacity. <br />Verified drainage. <br />Verified installation of deflector plates and containment of all pipes within UDC and deflector plates. <br />Per technician, the annular sensors were rewired, but not replaced. <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: <br />EH Specialist: STACY RIVERA <br />Name and Title: Leonardo Rangel, Technician <br />Phone: (209) 468-3440 <br />FA0001570 SR0079662 SC298 03/05/2019 <br />EHD 23-01 Rev. 06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />