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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: SAFEWAY FUEL CENTER#2707 Date: 01/05/2022 <br /> Address: 6425 N PACIFIC AVE , STOCKTON 95207 <br /> Requestor: MARTY WETHMAN,ABLE MAINTENANCE INC Telephone: (408)213-6038 <br /> Program Element: 2308-UST RETROFIT Request#: SR0084150 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Sam Sousa ICC Service Tech/Installer Exp. Date: 06/25/2023 <br /> Manufacturer training: Bravo, 01/27/24 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On-site to verify; <br /> Dispenser foot prints is contained by the under dispeensor containment sumps. <br /> Visually inspect the piping within the dispenser for leaks. <br /> Witness functionality of monitoring systems. <br /> Note: Received alarm history prior to cold start for review. <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. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate($152). To schedule an <br /> appointment, please call (209)468-3420. <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: Email sent to;Aldo Basurto,Assistan <br /> EH Specialist: FREDERICK ERNEST Phone: (209)616-3026 <br /> FA0002409 SR0084150 SC298 01/05/2022 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />