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r I Environmental Health Department <br /> - I <br /> COUNTY— <br /> Greatness <br /> U T <br /> Greatness grows here, <br /> Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: TIWANA GAS& FOOD Date: 12/05/2022 <br /> Address: 1210 E HAMMER LN , STOCKTON 95210 <br /> Requestor: JANELLE DOCKHAM, NWESTCO, LLC Telephone: (661)631-3870 <br /> Program Element: 2308-UST RETROFIT Request#: SR0085659 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Henry Meraz ICC Service Tech/Installer Exp. Date: 02/11/2024 <br /> Manufacturer training: Hose Master, 11/22/23 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> -On-site to witness primary and secondary piping soap tests.All passed. <br /> -Verified secondary piping slope. <br /> -Verified all piping setbacks and cross-overs. <br /> NOTE: Since concrete was broken near the UDCs and piping, a secondary containment test must be performed on the UDCs <br /> and piping once the concrete is poured in accordance with the manufacturer's guidelines. A copy of the test report must be <br /> submitted within 30 days of the test. <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 Joe Landa, Construction M <br /> EH Specialist: SHEWIT WOLDEAREGAY Phone: (209)616-3063 <br /> FA0003730 SR0085659 SC298 12/05/2022 <br /> EHD 23-01 Rev.07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />