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ur I Environmental Health Department <br />41 t: SAN-6-JOAQU <br />vii fir: C (--) LJ Y Time In: <br />r <br />Time Out: <br />r'�JFOSX:, Careotness grows here. <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: 7 -ELEVEN INC STORE #41187 <br />Date: 01/05/2021 <br />Address: 1829 N WILSON WAY, STOCKTON 95205 <br />Requestor: LACY DODGE ON BEHALF OF 7 -ELEVEN INC, TAIT & ASSOCIATES <br />Telephone: (916) 669-1849 <br />Program Element: 2303 - UST/PIPING INSTALLATION <br />Request #: SR0082287 <br />Inspection Type: 131 - UST INSTALLATION INSPECTION <br />Onsite Service Technician: Juan Delgado <br />ICC Service Tech/Installer Exp. Date: 08/31/2021 <br />Manufacturer training: Xerxes, 01/02/22 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for tank testing of all three tanks at 5 PSI for 1 hour. All passed. <br />—Additional inspection are required. Refer to the approval letter dated October 8, 2020 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: <br />EH Specialist: STACY RIVERA <br />Name and Title: <br />Phone: <br />SR0082287 SC131 01/05/2021 <br />EHD 23-01 Rev. 06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />