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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: Nella Oil #427 <br />Date: 12/23/2021 <br />Address: 3300 Waterloo RD , STOCKTON 95205 <br />Requestor: VERONICA FREITAS, WALTON ENGINEERING INC <br />Telephone: (916) 373-1166 <br />Program Element: 2308 - UST RETROFIT <br />Request #: SR0084618 <br />Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br />Onsite Service Technician: David Delgado <br />ICC Service Tech/Installer Exp. Date: 09/18/2022 <br />Manufacturer training: OPW, 12/03/23 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for the following inspection on direct bury 87 spill container: <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 tank. <br />*Additional testing required (Secondary Containment testing on the 87 tank) see approval letter dated December 17, 2021 <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: <br />EH Specialist: PAUL NSO <br />Name and Title: E mail repot to: Anais Maurel, Environ <br />Phone: (209) 616-3049 <br />FA0003600 SR0084618 SC298 12/23/2021 <br />EHD 23-01 Rev. 09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />