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SANJI Environmental Health Department <br /> COL) NTY Time In: <br /> Time Out: <br /> rrrws Ter!. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: ARCO AM/PM MANTECA Date: 03/17/2020 <br /> Address: 2050 CRESTWOOD AVE, MANTECA 95336 <br /> Requestor: CHRIS BROWN, PM DESIGN GROUP ONC (SUITE 102) Telephone: (707) 921-1204 <br /> Program Element: 2303- UST/PIPING INSTALLATION Request#: SR0078213 <br /> Inspection Type: 131 - UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Donny Gilmer ICC Service Tech/Installer Exp. Date: 11/18/2021 <br /> Manufacturer training: NOV, 12/14/21 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections: <br /> -Witnessed integrity testing of all the STP and Fill Sumps prior to back fill - Passed <br /> -Verified brine type ok <br /> -Witnessed brine addition prior to back fill - passed <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. <br /> 'Additional inspections are required. Refer to the approval letter dated July 26, 2019 for a list of inspections needed. <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: Donny Gilmer, Project Manager <br /> EH Specialist: PAUL NSO Phone: (209)468-3432 <br /> SR0078213 SC131 03/17/2020 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />