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r SANJOAQUI Environmental Health Department <br /> C U N T Time In:Time Out: <br /> Greatness grows here, <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: 7-ELEVEN INC STORE#41187 Date: 09/23/2021 <br /> Address: 1829 N WILSON WAY, STOCKTON 95205 <br /> Requestor: LACY DODGE ON BEHALF OF 7-ELEVEN INC, TAIT&ASSOCIATES Telephone: (916)669-1849 <br /> Program Element: 2303-UST/PIPING INSTALLATION Request#: SR0082287 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Clint Fuhrman ICC Service Tech/Installer Exp. Date: 05/03/2023 <br /> Manufacturer training: VR, 04/21/23;VMI, 05/03/23; OPW, 05/05/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections: <br /> -Witnessed monitoring system functionality testing after fuel delivery-Passed <br /> -Witnessed Leak detector testing-Passed <br /> -Verified communication at end points of each vacuum zone and vacuum monitored sumps <br /> *Needed for final approval <br /> -All outstanding up to date permit fees must be paid prior to receiving the final approval to operate <br /> -Certification of installation form for installed tank system submitted into CERS <br /> -Copies of required documents must be submitted into CERS <br /> Refer to the approval letter dated October 8, 2020. <br /> *This facility is not approve to operate the UST system. <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: E mailed to Ethan Valburg, Environm <br /> EH Specialist: PAUL NSO Phone: (209)616-3049 <br /> SR0082287 SC298 09/23/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />