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Time In: <br /> Time Out: <br /> opQ.�tN. San Joaquin County <br /> .X Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> �<<FORtN <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: VAN DE POL ENTERPRISES INC Date: 08/19/2019 <br /> Address: 816 E FRONTAGE RD , RIPON 95366 <br /> Requestor: DONLEE PUMP COMPANY, DONLEE PUMP COMPANY Telephone: (209)537-9396 <br /> Program Element: 2308-UST RETROFIT Request#: SR0080338 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Alex Brambila ICC Service Tech/Installer Exp. Date: 05/11/2021 <br /> Manufacturer training: FF, 06/25/21 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections: <br /> -Verified overfill measurements and calculations for the Defender Series Overfill Prevention w/flapper valve in the 87, 91, and <br /> diesel tanks.The Overfill Prevention Equipments were already constructed and inside the tanks before the inspector was <br /> onsite. The technician used the"OPV Drop Tube Calculation E-Form"to confirm proper positioning. The Overfill Prevention <br /> Equipment for all tanks were pulled out during the service request inspection and measurements were verified. Overfill for all <br /> tanks were calculated at 95%. <br /> -According to the technician,there were no ball floats(flow restrictors)installed. <br /> -Verified flapper functionality for the 87, 91 and diesel product Overfill Prevention Equipments. <br /> -Verified 5 gallon capacity for the 87, 91, diesel spill containers. <br /> -Verified drainage for the 87, 91, and diesel spill containers. <br /> -Witnessed one hour hydrostatic testing of the 87, 91 and diesel spill containers. All passed <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: alex brambila, service tech <br /> EH Specialist: SHEWIT WOLDEAREGAY Phone: (209)468-0216 <br /> FA0003911 SR0080338 SC298 08/19/2019 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />