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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: COUNTRY MART GAS& FOOD Date: 09/01/2021 <br /> Address: 34243 S CHRISMAN RD , TRACY 95304 <br /> Requestor: DEBORAH JONES, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2308-UST RETROFIT Request#: SR0083263 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Joseph Bartholdi ICC Service Tech/Installer Exp. Date: 04/13/2023 <br /> Manufacturer training: VR, 04/19/23; NOV, 05/20/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness: <br /> -sensor functionality(UDC brine and UDC 208 sensors all function correctly) <br /> -verified dispenser footprints are contained by the UDCs <br /> -verified vacuum hold on diesel tank at 3 psi <br /> -assisted owner with CERS updates for permit <br /> The diesel UST system at this facility is approved to receive fuel. <br /> Please remember a secondary containment test for the diesel piping is required 6 months after installation. Provide 48 hours <br /> notification to EHD when this test is scheduled. <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: Taranjit Sandhu, Owner <br /> EH Specialist: CAROL PRESTO Phone: (209)616-3061 <br /> FA0003290 SR0083263 SC298 09/01/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />