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ur I Environmental Health Department <br /> 41 t: SAN-6-JOAQU <br /> vii fir : C(--)LJ Y Time In: <br /> r <br /> Time Out: <br /> r'�JFOSX:, Careotness grows here. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: WATERLOO LIQUOR Date: 01/14/2021 <br /> Address: 2512 E WATERLOO RD , STOCKTON 95205 <br /> Requestor: MEGAN MITCHELL, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2308-UST RETROFIT Request#: SR0082719 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Mike Kennard ICC Service Tech/Installer Exp. Date: 06/19/2021 <br /> Manufacturer training: FF, 07/25/21 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> -Witnessed one hour hydrostatic testing of the 87 spill container. Passed. <br /> -Verified 5 gallon capacity and drainage of the 87 spill container. <br /> -Confirmed measurements of the 87 drop tube and mechanical flapper-overfill is at or below 95%. <br /> Per technician, no ball floats are installed. <br /> This facility is approved to receive fuel. <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: Mike Kennard,Technician <br /> EH Specialist: STACY RIVERA Phone: <br /> FA0004064 SR0082719 SC298 01/14/2021 <br /> EHD 23-01 Rev.06/30/15 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />