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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: Love's Travel Stop#538 Date: 06/16/2022 <br /> Address: 15250 N THORNTON RD , LODI 95242 <br /> Requestor: CARRIE MILLER, ELITE IV CONTRACTORS Telephone: (209)461-6337 <br /> Program Element: 2308-UST RETROFIT Request#: SR0085216 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Adrian Rodriguez ICC Service Tech/Installer Exp. Date: 04/27/2023 <br /> Manufacturer training: OPW, 05/19/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site to witness overfill prevention of 87, 91 and Diesel drop tubes. <br /> Verified flapper functionality. <br /> Verified shut off at<95% using Xerxes tank charts. <br /> Verified the presence of ball floats. Ball floats were removed while on site. <br /> Facility is approved to receive fuel in the 87, 91 and diesel tanks. <br /> To minimize person to person contact EHD is choosing to write the name of the person receiving the report instead of having <br /> them 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 Carrie Miller, Contractor <br /> EH Specialist: GABRIELA GARCIA-MEJIA Phone: (209)616-3037 <br /> FA0021886 SR0085216 SC298 06/16/2022 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />