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S A N J Q Q Q U IN Environmental Health Department <br />C O U N T Y Time In: <br />Time Out: <br />Greorness grows here. <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: PACIFIC CAR WASH/MARKETPLACE INC <br />Date: 06/24/2021 <br />Address: 4405 PACIFIC AVE, STOCKTON 95207 <br />Requestor: SARAH JABLONSKY, WALTON ENGINEERING <br />Telephone: (916) 373-1165 <br />Program Element: 2308 - UST RETROFIT <br />Request #: SR0083550 <br />Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br />Onsite Service Technician: Brent Bowen <br />ICC Service Tech/Installer Exp. Date: 06/09/2023 <br />Manufacturer training: VR, 04/23/23; VMI, 10/02/22; Tank Tester, 08/31/22 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site to verify dispenser footprints contained by the under dispenser containment sumps. Visual inspection to confirm no <br />leaks from piping and fuel filters drain directly into under dispenser containment sumps. Witnessed monitoring certification <br />and secondary containment testing. All components passed per service technicians. <br />All conditions of permit have been met. <br />Additional tech certifications: <br />Jarrod Cooke, ICC tech 3/18/2023, VPLT 3/21/2023 <br />David Delgado, ICC tech 12/6/21, Modern Welding 3/30/2022, NOV Fiber Glass Systems' TQIP 1/2/2023 <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: LYDIA BAKER <br />Name and Title: Emailed to Ross Hillesheim, Manage <br />Phone: (209) 616-3046 <br />FA0007787 SR0083550 SC298 06/24/2021 <br />EHD 23-01 Rev. 09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />