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SANOAQU I N Environmental Health Department <br /> COU NI T Y I Y Time In: <br /> + _,fr Time Out: <br /> . •- Greotr+ess �row3 here, <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: VALLEY PACIFIC FRESNO AVE CARDLOCK Date: 01/25/2021 <br /> Address: 1524 FRESNO AVE , STOCKTON 95206 <br /> Requestor: MIKE ELIASON,VALLEY PACIFIC PETROLEUM Telephone: (209)993-8793 <br /> Program Element: 2308-UST RETROFIT Request#: SR0083189 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Josh Simmons ICC Service Tech/Installer Exp. Date: 01/15/2022 <br /> Manufacturer training: OPW, 01/21/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following: <br /> • Verified 5 gallon capacity <br /> • Witnessed 1 hour hydrostatic test <br /> • Verified proper drainage <br /> Facility is approved to receive fuel in the diesel tank. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead of having them <br /> sign. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate($152). To schedule an <br /> appointment, please call (209)468-3420. <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: Nicolas Poblano, Cardlock Superviso <br /> EH Specialist: CAROL PRESTO Phone: (209)616-3061 <br /> FA0007491 SR0083189 SC298 01/25/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />