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SAN JOANI Environmental Health Department <br /> COU N T Time In: <br /> Time Out: <br /> (',reotr+ess grows ho,— <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: 7-ELEVEN INC#20632 Date: 12/11/2020 <br /> Address: 4627 DA VINCI DR, STOCKTON 95207 <br /> Requestor: NICHOLAS ROWE, LC SERVICES Telephone: (559) 892-5287 <br /> Program Element: 2303- UST/PIPING INSTALLATION Request#: SR0079419 <br /> Inspection Type: 131 - UST INSTALLATION INSPECTION <br /> Onsite Service Technician: Tim Hardin ICC Service Tech/Installer Exp. Date: 04/25/2021 <br /> Manufacturer training: NOV,02/20/21; Bravo, 03/10/21 <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 /> -Witnessed secondary containment testing of 91 Fill, 91 STP, diesel Fill, diesel STP,87 Fill, and 87 STP containment sumps <br /> prior to backfilling <br /> All passed. <br /> -Witness start of pre ELD testing. <br /> * This facility is not approve to operate the UST system for additional testing see approval letter dated August 8, 2019. <br /> * Note that if Xerxes containment sumps certification for Tim Hardin is NOT received by end of day today 12/11/2020, we will <br /> not accept the secondary containment test results as valid you will have to reschedule another testing date. <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: Name and Title: Larry Carpenter, Project Manager <br /> EH Specialist: PAUL NSO Phone: (209) 616-3049 <br /> FA0002541 SR0079419 SC131 12/11/2020 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />