Laserfiche WebLink
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: H&M- BW#98 Date: 08/14/2019 <br /> Address: 2501 JACKSON AVE , ESCALON 95320 <br /> Requestor: MARTY WEITHMAN, SERVICE STATIONS SYSTEMS, INC. Telephone: (408)213-6038 <br /> Program Element: 2308-UST RETROFIT Request#: SR0080752 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Sam Sousa ICC Service Tech/Installer Exp. Date: 07/12/2021 <br /> Manufacturer training: OPW, 12/14/20 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections: <br /> -Witnessed 5 gallon capacity of diesel direct-bury spill container. <br /> -Witnessed 1 hour hydrostatic testing. Passed <br /> -Verified drainage. Passed <br /> -Since concrete was broken near the tank, a secondary containment test was performed on the tank in accordance with the <br /> manufacturer's guidelines. Passed <br /> NOTE: This facility is approved to operate. <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: Sam Sousa, Service Tech. <br /> EH Specialist: SHEWIT WOLDEAREGAY Phone: (209)468-0216 <br /> FA0003910 SR0080752 SC298 08/14/2019 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />