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S A N J Q Q Q U IN Environmental Health Department <br /> C O U N T Y Time In: <br /> Time Out: <br /> Greorness grows here. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: PACIFIC SERVICE STATION Date: 03/29/2022 <br /> Address: 6131 PACIFIC AVE , STOCKTON 95207 <br /> Requestor: MOHAMMAD HUSSAINI, GREAT GAS PACIFIC INC Telephone: (510)257-6673 <br /> Program Element: 2308-UST RETROFIT Request#: SR0083737 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Brian Roth ICC Service Tech/Installer Exp. Date: 11/14/2023 <br /> Manufacturer training: OPW, 10/21/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness overfill prevention verification of the 87 drop tube. Per Brian Roth (Technician), drop tube passed at 93%. <br /> Verified functionality of flapper. Verified no ball floats installed. Verified installation of deflector plates on all dispensers. <br /> This site needs further testing. Please refer to permit approval letter for the required inspections. A 48-hour notice is required <br /> for all inspections. <br /> Provide test results for today's overfill prevention verification to ust@sjgov.org within 30 days. Please include tank chart and <br /> calculations with test results. <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: Emailed to Mohammad Hussaini, Ow <br /> EH Specialist: LYDIA BAKER Phone: (209)616-3046 <br /> FA0002324 SR0083737 SC298 03/29/2022 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />