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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: BAI PETRO INC.#83680 Date: 11/12/2021 <br /> Address: 14931 N FLAG CITY BLVD , LODI 95242 <br /> Requestor: DEBORAH JONES, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2308-UST RETROFIT Request#: SR0083730 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Adrian Rodriguez ICC Service Tech/Installer Exp. Date: 04/27/2023 <br /> Manufacturer training: OPW, 05/19/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections 87, 91 and diesel spill containers and drop tubes: <br /> 1)Overfill prevention equipment verification: <br /> -Measurement of drop tubes, set at 94%tank volume, checked with tank charts <br /> -Verified flapper functionality <br /> -Verified ball floats, no ball floats installed <br /> 2)Spill bucket test: <br /> -Verified 5 gallon capacity <br /> -Verified drainage <br /> -Witnessed one hour hydrostatic test <br /> All passed. <br /> This facility is approve to receive fuel in the 87, 91 and diesel tanks. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead of having them <br /> 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: E mailed to: Shawn Sodhi, Environme <br /> EH Specialist: PAUL NSO Phone: (209)616-3049 <br /> FA0007287 SR0083730 SC298 11/12/2021 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />