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r: � I I I Environmental Health Department <br /> Y SA N U <br /> rk.1 wti COUNTY Time In: <br /> Time Out: <br /> Greorness grows here, <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: SAFEWAY FUEL CENTER#2600 Date: 04/30/2021 <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: Ernie Ybarra ICC Service Tech/Installer Exp. Date: 09/21/2021 <br /> Manufacturer training: NOV, 09/23/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness: <br /> -primary piping soap test of all piping and penetrations <br /> - 1 hour pneumatic pressure test at 50 psi <br /> -no leaks were observed during the soap test <br /> -no drop in pressure was observed after 1 hour <br /> Additional inspections are required. Please see approval permit letter dated February 22, 2021 item number 3 for list of <br /> additional inspections required. <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 04/30/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />