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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: SMK CHEVRON Date: 08/23/2019 <br /> Address: 25651 N HWY 99 ,ACAMPO 95220 <br /> Requestor: MEGAN MITCHELL, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2308-UST RETROFIT Request#: SR0080723 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Chris Adams ICC Service Tech/Installer Exp. Date: 04/19/2020 <br /> Manufacturer training: FF, 07/25/21 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections: <br /> -Verified 95%overfill measurements and calculations for the Defender Series overfill prevention valve in the 87, 91,and diesel <br /> tanks. Overfill for all tanks were calculated at less than 95%. <br /> -No ball floats present. <br /> -Verified functionality of the flapper for all three tanks(87, 91, and diesel). <br /> -Verified 5 gallon capacity of the 87, 91, and diesel spill containers. <br /> -Verified drainage of the 87, 91, and diesel spill containers. <br /> -Witnessed one hour hydrostatic testing of the 87, 91 and diesel spill containers.All passed. <br /> *This facility is approved for fuel delivery. <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 Tech <br /> EH Specialist: SHEWIT WOLDEAREGAY Phone: (209)468-0216 <br /> FA0003835 SR0080723 SC298 08/23/2019 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />