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SAN JOAHI <br />CQU NTY <br />' SS grows heir <br />Environmental Health Department <br />Time In: <br />Time Out: <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: CHEVRON STATION #209167 <br />Date: 09/13/2019 <br />Address: 1234 E YOSEMITE AVE, MANTECA 95336 <br />Requestor: LIDDY MCKENZIE, GETTLER RYAN INC. <br />Telephone: (925) 551-7555 <br />Program Element: 2308 - UST RETROFIT <br />Request #: SR0080291 <br />Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br />Onsite Service Technician: Raymond Simms <br />ICC Service Tech/Installer Exp. Date: 06/25/2020 <br />Manufacturer training: VMI, 12/10/20; VR, 10/04/20 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for : <br />-verification of the dispenser foot prints contained by the under dispenser containment (UDC) sumps and any potential leaks <br />from piping and fuel filters drainage into UDC's. Fuel filters are out of the UDC compartment cannot drain directly into UDC's <br />require deflector plates to be installed in all UDC's <br />-Leak detector test conducted . 87 and 91 passed <br />-Verify sensor functionality <br />Veeder root sensors #208 in all UDC's and #209 in STP sumps and they shutdown STP in case of leak. <br />-Installation of new red jacket line leak detectors <br />-New module to existing veeder root monitoring panel and System cold start conducted. <br />-Witness Secondary containment testing on Vacuum - Passed <br />This facility is approve to operate the UST system pending, final inspection by EHD of deflector plates installation at all UDC's, <br />update of CERS records and receipt of all test results . <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: <br />EH Specialist: PAUL NSO <br />Name and Title: Desmond Pisano, Foreman <br />Phone: (209) 468-3432 <br />FA0012532 SR0080291 SC298 09/13/2019 <br />EHD 23-01 Rev. 06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />