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S A N J Q Q Q U IN Environmental Health Department <br /> C O U N T Y Time In: <br /> Time Out: <br /> Greorness grows here. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: 7-ELEVEN INC#20632 Date: 12/10/2020 <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: 06/28/2021 <br /> Manufacturer training: NOV, 04/25/21 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness: <br /> -secondary piping soap test <br /> -one hour pressure test at manufacturer's recommendations <br /> -integrity testing of vent sump and under dispenser containment(UDC) <br /> -all components passed <br /> Manufacturer certifications for the Bravo vent sump and OPW Flexworks UDC were not provided at the time of the inspection. <br /> Please provide manufacturer certifications for Tim Hardin immediately. <br /> If certifications are not provided,the integrity testing for the vent sump and UDC will need to be repeated by a certified ICC <br /> installer who is certified by the manufacturer for these components. <br /> This site needs additional testing prior to backfilling. <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: Emailed to Larry Carpenter, Contract <br /> EH Specialist: VICKY VANG-LEE Phone: (209)616-3028 <br /> FA0002541 SR0079419 SC131 12/10/2020 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />