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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: SAFEWAY FUEL CENTER#2600 Date: 04/21/2021 <br /> Address: 1987 W ELEVENTH ST , TRACY 95376 <br /> Requestor: DAN RAUSCHER, GRANITE PETROLEMMN INC Telephone: (509)482-7016 <br /> Program Element: 2308-UST RETROFIT Request#: SR0082924 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: ICC Service Tech/Installer Exp. Date: <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness soil sampling under UDCs and removed piping. Soil samples taken at 2 feet depth using a hand auger. 18 <br /> samples were taken. <br /> Note: <br /> No stockpile samples were taken at this time. Per on site supervisor,the stockpile was taken to Alegra Trucking location and <br /> was combined. Stock pile will not be returned to facility as originally planned. <br /> Additional inspections are still required. See approval permit letter for list of inspections under number 3. <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: Name and Title: Ernie Ybarra, Supervisor <br /> EH Specialist: CAROL PRESTO Phone: (209)616-3061 <br /> FA0013503 SR0082924 SC298 04/21/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />