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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: CHEVRON USA#201761* Date: 10/08/2019 <br /> Address: 1103 S MAIN ST , MANTECA 95337 <br /> Requestor: JAMES ALEXANDER,WAYNE PERRY INC Telephone: (916)646-9680 <br /> Program Element: 2308-UST RETROFIT Request#: SR0080166 <br /> Inspection Type: 198-UST RETROFIT REPAIR PLAN CHECK <br /> Onsite Service Technician: Erick Chavez ICC Service Tech/Installer Exp. Date: 04/08/2020 <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> **EHD was unable to witness the following: <br /> -5 gallons capacity on the 87(1), 87(2), and 91 spill containers. <br /> -Proper drainage. <br /> -A one hour hydrostatic test for the 87(1), 87(2), and 91 spill containers. <br /> EHD was on site at 1:57pm for 2:00pm appointment.According to the service technician on site, Erick Chavez,they were <br /> having a hard time removing the old buckets and don't think they will be done installing the three new spill containers before <br /> 4:00 pm. <br /> ***This facility is NOT approved to operate prior to EHD's inspection and approval.A 48-hour notification is required to be <br /> submitted to the EHD via ust@sjgov.org.All repaired components must be tested within 30 days of repairs and test results <br /> must be submitted to the EHD within 30 days of testing. <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: Eric Chavez, Service Tech <br /> EH Specialist: SHEWIT WOLDEAREGAY Phone: (209)468-0216 <br /> FA0004521 SR0080166 SC198 10/08/2019 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />