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SANOAQU I N Environmental Health Department <br /> COUNTY IY <br /> Greotr+ess �row3 here. <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: COSTCO WHOLESALE#1091 Date: 05/17/2022 <br /> Address: 2680 REYNOLDS RANCH PKWY, LODI 95240 <br /> Requestor: M.ALEXIA INIGUES, BARGHAUSEN CONSULTING ENGINEERS INC Telephone: (425)251-6222 <br /> Program Element: 2308-UST RETROFIT Request#: SR0084484 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Mathew Campbell ICC Service Tech/Installer Exp. Date: 04/10/2023 <br /> Manufacturer training: FF, 01/10/23;VR, 04/11/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections on the 87#1, 87#2 and 91 tanks: <br /> Overfill prevention equipment verification-87#1, 87#2, and 91 tanks drop tubes: <br /> Witnessed: <br /> -Measurement of drop tubes, Franklin fuel system Defender Series Overfill Prevention Valve(OPV)set at less than 95%tank <br /> volume, <br /> -Verified flapper functionality <br /> -Verified ball floats, ball floats installed. Technician remove ball floats. <br /> -Cold start the Veeder root monitoring panel (TLS 350R)and verified sensors functionality. <br /> *Please log into CERS and update the overfill prevention equipment options for all tanks. <br /> *This facility is approve to receive fuel in the 87#1,87#2, and 91 tanks. <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: E mail report to: Sharon Saknit, Envir <br /> EH Specialist: PAUL NSO Phone: (209)616-3049 <br /> FA0020431 SR0084484 SC298 05/17/2022 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />