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SAN JOAOUI <br />CQU NTY <br />' SS grows hvj— <br />Environmental Health Department <br />Time In: <br />Time Out: <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: NORTH POLE GAS & FOOD INC <br />Date: 07/23/2020 <br />Address: 574 W GRANT LINE RD, TRACY 95376 <br />Requestor: MEGAN MITCHELL, ELIE IV CONTRACTORS <br />Telephone: (209) 461-6337 <br />Program Element: 2308 - UST RETROFIT <br />Request #: SR0081958 <br />Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br />Onsite Service Technician: Michael KENNARD <br />ICC Service Tech/Installer Exp. Date: 06/19/2021 <br />Manufacturer training: Bravo, 04/02/22 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for the following: <br />- Verified dispensers footprint contained by the under dispenser containment sumps (UDC) <br />- Verified piping within the dispensers no evidence of any leaks <br />- Verified Installation of Bravo Conversion frames <br />* Submit to EHD test results of the functionality of the monitoring system to verify monitoring has been restored to normal after <br />cold start. <br />* The tank owner or operator shall log into the California Environmental Reporting System (CERS) and ensure all <br />UST information is current. <br />*This facility is approve to operate the UST system after functionality of the monitoring system is restored to normal after cold <br />start. <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 />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: PAUL NSO <br />Name and Title: Micheal Kennard, Service Tech <br />Phone: (209) 468-3432 <br />FA0003164 SR0081958 SC298 07/23/2020 <br />EHD 23-01 Rev. 06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />