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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: 4600 S CORRAL HOLLOW RD <br />Date: 01/19/2022 <br />Address: 4600 S CORRAL HOLLOW RD, TRACY 95377 <br />Requestor: SARAH JABLONSKY - CONSTRUCTION MANAGER, WALTON ENGINEER <br />Telephone: (916) 373-1165 <br />Program Element: 2303 - UST/PIPING INSTALLATION <br />Request #: SR0083413 <br />Inspection Type: 131 - UST INSTALLATION INSPECTION <br />Onsite Service Technician: Juan Delgado <br />ICC Service Tech/Installer Exp. Date: 08/31/2022 <br />Manufacturer training: Xerxes, 01/02/23 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for the installation of new Xerxes double -walled fiberglass USTs <br />- 25,000 gallon <br />- 10,000 gallon base, 10,000 gallon end <br />- Inside of tanks was inspected by the contractor on site and stated to be clean and brine -free. <br />- Verified the use of the manufacturer installation checklist at the time of inspection. <br />- Verified presence of deadmen and use of anchor straps. <br />- Verified use of proper pea gravel backfill. <br />- Witnessed tank set. <br />- Verified the application of additional corrosion protection on all metal anchor components. <br />- Witnessed backfilling of the tank pit and compaction of the backfill. <br />"Additional inspections are required. Refer to the permit approval letter dated December 15, 2021 for a list of inspections <br />needed and provide a 48-hour notice by emailing ust@sjgov.org. <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: ELIANNA FLORIDO <br />Name and Title: Emailed to Richard Walton, Contracto <br />Phone: (209) 616-3050 <br />SR0083413 SC131 01/19/2022 <br />EHD 23-01 Rev. 09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />