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SAN JOANIN <br />COU CITY <br />(',reotr+ess grows ho, <br />­ <br />Environmental Health Department <br />Time In: <br />Time Out: <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: 7 -ELEVEN INC STORE #41187 <br />Date: 03/16/2021 <br />Address: 1829 N WILSON WAY, STOCKTON 95205 <br />Requestor: LACY DODGE ON BEHALF OF 7 -ELEVEN INC, TAIT & ASSOCIATES <br />Telephone: <br />(916) 669-1849 <br />Program Element: 2303 - UST/PIPING INSTALLATION <br />Request #: <br />SR0082287 <br />Inspection Type: 131 - UST INSTALLATION INSPECTION <br />Onsite Service Technician: Juan Delgado <br />ICC Service Tech/Installer Exp. Date: <br />08/31/2021 <br />Manufacturer training: NOV, 01/02/22 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for the following inspection: <br />- Verified secondary piping slope at 1/8 inch per foot to the containment sumps <br />- Verified piping setbacks, cross overs and burial depth <br />- Observed three areas in the tank pit where upper piping and lower piping make contact. Rubber spacers were taped on the <br />lower pipe in areas where cross over piping made contact. Provide written documentation from manufacturer approving this <br />installation method. If written documentation can not be provided, piping shall be installed according to manufacturer's <br />guidelines. <br />- Witnessed secondary containment retest of two Under -Dispenser Containment. Both UDC's passed. <br />* This facility is not approved to operate the UST system. For additional testing see approval letter dated October 8, 2020. <br />To minimize person to person contact EHD is choosing to write the name of the person receiving the report instead of having <br />them sign. <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: FREDERICK ERNEST <br />Name and Title: Juan Delgado, Installer <br />Phone: (209) 616-3026 <br />SR0082287 SC131 03/16/2021 <br />EHD 23-01 Rev. 09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />