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SAN J O A Q U I N Environmental Health Department <br /> —COUNTY— Time In: <br /> Time Out: <br /> i�C1FaR'' GreQl tress grows her— <br /> Underground <br /> ey—Underground Storage Tank Program Service Request Inspection Report <br /> Name of Facility: 7-ELEVEN INC#38616 Date: 08/19/2022 <br /> Address: 601 W CAROLYN WESTON BLVD , STOCKTON 95206 <br /> Requestor: ROBERT FORLOINE, PM DESIGN GROUP INC Telephone: (707)387-9883 <br /> Program Element: 2303-UST/PIPING INSTALLATION Request#: SR0082546 <br /> Inspection Type: 298-UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Landon Zamora ICC Service Tech/Installer Exp. Date: 06/08/2023 <br /> Manufacturer training: VR, 04/27/23; OPW, 02/24/24 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following: <br /> -Verified leak monitoring communication for all installed vacuum, pressure, or hydrostatic(VPH)components. <br /> -Verified dispenser footprints are contained by the UDC's. <br /> -Passing ELD test results received by the EHD. <br /> -Verified VPH components installation. <br /> -Verified measurement of drop tubes to verify 95%tank volume shut off and flapper functionality. <br /> -Verified minimum 5-gallon capacity, proper drainage of spill buckets and passing 1-hour hydrostatic test. <br /> -Verified monitoring system functionality. <br /> -Valid California Department of Tax and Fee Administration (CDTFA)number. <br /> Facility is approved to drop fuel. Facility is NOT approved to operate. See approval letter dated 3/10/2021 for additional <br /> requirements 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 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 Crystal Justice, Engineerin <br /> EH Specialist: GABRIELA GARCIA-MEJIA Phone: (209)616-3037 <br /> SR0082546 SC298 08/19/2022 <br /> EHD 23-01 Rev.09/16/2020 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />