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°• Environmental Health Department <br />�. �J r� SHAWN <br />t 7Y- L. <br />Y <br />ttlir-' COUNTY— <br />Greol less grows he:. . <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: FAST N EASY MART #104 <br />Date: 05/16/2023 <br />Address: 16460 GOLDEN VALLEY PKWY, LATHROP 95330 <br />Requestor: MUHAMMAD BILAL, RIVER ISLAND CHEVRON <br />Telephone: (707) 486-8894 <br />Program Element: 2303 - UST/PIPING INSTALLATION <br />Request #: SR0086111 <br />Inspection Type: 298 - UST SERVICE REQUEST - FIELD ACTIVITY <br />Onsite Service Technician: Alves Scot <br />ICC Service Tech/Installer Exp. Date: 12/02/2024 <br />Manufacturer training: NOV, 07/23/24; Bravo, 01/08/24 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for the following inspections: <br />- Witnessed primary piping soap test of all piping and penetrations ( product, vapor recovery, vent and chase) and one hour <br />pneumatic pressure test at 50psi operating pressure - All passed <br />- Witnessed integrity testing of the UDCs and vent sumps only at 5psi for one hour pneumatic pressure- all passed <br />- Witnessed initial brine addition (bravo brine) in UDCs and vent sumps only. <br />*This facility is not approve to receive fuel in the tanks additional inspections are required. Refer to the approval letter dated <br />April 4, 2023 for a list of inspections needed. <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: <br />EH Specialist: PAUL NSO <br />Name and Title: E mail report to: Muhammad Bilal, Ow <br />Phone: (209) 616-3049 <br />SR0086111 SC298 05/16/2023 <br />EHD 23-01 Rev. 07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />