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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: H&M- BW#98 Date: 03/25/2022 <br /> Address: 2501 JACKSON AVE , ESCALON 95320 <br /> Requestor: JAMES OTTO, LC SERVICES Telephone: (559)444-1730 <br /> Program Element: 2308-UST RETROFIT Request#: SR0084893 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Charles Shrabel ICC Service Tech/Installer Exp. Date: 07/17/2022 <br /> Manufacturer training: <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness overfill prevention of 87 drop tube. <br /> Verified flapper functionality. <br /> Verified shut off at<95% using Modern Welding tank charts. <br /> Technician did not have a manufacturer's certification for flapper installation on site. Immediately submit a copy of the <br /> certification to the EHD. If the certification cannot be provided, overfill inspection will need to be re-conducted by a properly <br /> certified technician. <br /> If the technician has current manufacturer's certification this facility is approved to receive fuel in the 87 tank. <br /> If the technician does not have a current manufacturer's certification this facility is NOT approved to receive fuel in the 87 tank. <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 Monica Farhat, Environme <br /> EH Specialist: STACY RIVERA Phone: (209)616-3043 <br /> FA0003910 SR0084893 SC298 03/25/2022 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />