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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: NORTH POLE GAS &FOOD INC Date: 03/16/2022 <br /> Address: 574 W GRANT LINE RD ,TRACY 95376 <br /> Requestor: NIK ZAGOROV, ECO-ATEK COMPLIANCE INC Telephone: (415)740-8590 <br /> Program Element: 2308-UST RETROFIT Request#: SR0084878 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Marco Alejos ICC Service Tech/Installer Exp. Date: 04/03/2023 <br /> Manufacturer training: OPW, 02/23/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site inspection: <br /> -Verified 5-gallon capacity on 91 spill container <br /> -Witnessed 1 hour hydrostatic test on the 91 spill container <br /> -Verified 91 drop tube is at 95%or less tank volume shut off <br /> -Verified flapper functionality on 91 drop tube <br /> -Verified ball floats are not present on the 91 tank. Ball floats were not observed in the 91 vapor pipe. <br /> -Verified corrosion protection on 87 spill container. <br /> Additional inspections required: <br /> -5-gallon capacity verification on 87 spill container after concrete has set <br /> - 1 hour hydrostatic test(or equivalent)on the 87 spill container after concrete has set <br /> This facility is approved to receive fuel in the 91 tank. 87 tank is pending 5-gallon capacity verification and 1 hour hydrostatic <br /> test. Okay to backfill around the 87 spill container. <br /> Please refer to revised approval letter dated March 16, 2022 for additional information. <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 Nik Zagorov, Contractor <br /> EH Specialist: CAROL PRESTO Phone: (209)616-3061 <br /> FA0003164 SR0084878 SC298 03/16/2022 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />