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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: 05/05/2021 <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; Bravo, 10/21/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness: <br /> -Secondary piping soap test of all piping and penetrations <br /> -One-hour pressure test at 5psi <br /> -Start of sumps and UDCs integrity testing. Filled with water above penetrations.Will verify tomorrow levels of water in sumps <br /> and UDCs. <br /> Additional inspections are required. Please see permit approval letter item#3. Please provide written notification to <br /> ust@sjgov.org to arrange appointments.48 hour notice is required for inspection appointments. <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: Ernie Ybarra, Supervisor <br /> EH Specialist: CAROL PRESTO Phone: (209)616-3061 <br /> FA0013503 SR0082924 SC298 05/05/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />