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S A N J Q Q Q U IN Environmental Health Department <br />COUNTY Ti <br />Amended 10/18/2021 Tlme: <br />me Outut: <br />Greorness grows here. <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: QUIK STOP MARKET #144 <br />Date: 10/18/2021 <br />Address: 7272 WEST LN , STOCKTON 95209 <br />Requestor: DEBORAH JONES, ELITE IV CONTRACTORS <br />Telephone: (209) 461-6337 <br />Program Element: 2308 - UST RETROFIT <br />Request #: SR0083601 <br />Inspection Type: 298 - UST RETROFIT REPAIR INSPECTION <br />Onsite Service Technician: <br />ICC Service Tech/Installer Exp. Date: <br />Manufacturer training: <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for the following: <br />- Verified dispenser footprints contained by the UDCs; any potential leaks from piping and fuel filters must drain directly into the <br />UDCs. <br />- Visual inspection of the piping within the dispensers. No leaks was observed. <br />NOTE: Deflector plates are installed in all UDCs. Update the scope of work and parts list. <br />To minimized person to person contact EHD is choosing to write the name of the person receiving the report instead of having <br />them 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: KRISTINA SAETERN <br />Name and Title: Emailed to Deborah Jones, Administr <br />Phone: (209) 616-3045 <br />FA0002570 SR0083601 SC298 10/18/2021 <br />EHD 23-01 Rev. 09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />