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SAN JOANIN <br />COU CITY <br />(',reotr+ess grows ho,— <br />Environmental Health Department <br />Time In: <br />Time Out: <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: BILLJAR VALERO <br />Date: 04/15/2021 <br />Address: 153 E ELEVENTH ST, TRACY 95376 <br />Requestor: DEBORAH JONES, ELITE IV CONTRACTORS <br />Telephone: (209) 461-6337 <br />Program Element: 2308 - UST RETROFIT <br />Request #: SR0083201 <br />Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br />Onsite Service Technician: Joseph Bartholdi <br />ICC Service Tech/Installer Exp. Date: 04/14/2023 <br />Manufacturer training: Bravo, 04/02/22; VR, 04/16/21 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for the following inspections: <br />- Verified dispenser foot prints contained by the under dispenser containment (UDC) sumps, primary product piping and fuel <br />filters drainage into UDC's. <br />- Verified Bravo conversion frames installed in all UDCs <br />- Witnessed sensor functionality: <br />Veeder root sensors #208 in all UDC's, annular, fill and STP sumps sensors. <br />- Verified monitoring System panel ( Gilbarco EMC) after cold start - normal. <br />All passed. <br />This facility is approve to operate the UST system. <br />* The tank owner or operator shall log into the California Environmental Reporting System (CERS) and ensure all UST <br />information is current. <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. <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: PAUL NSO <br />Name and Title: Joseph Bartholdi, Service Tech <br />Phone: (209) 616-3049 <br />FA0003709 SR0083201 SC298 04/15/2021 <br />EHD 23-01 Rev. 09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />