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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: ARCO AM-PM MOUNTAIN HOUSE Date: 10/10/2023 <br /> Address: 18095 W GRANT LINE RD , MOUNTAIN HOUSE 95391 <br /> Requestor: ALEX G CUEVAS/RAJA CHANDI, RAJA CHANDI GROUP Telephone: (213)448-3911 <br /> Program Element: 2303-UST/PIPING INSTALLATION Request#: SR0083410 <br /> Inspection Type: 298-UST SERVICE REQUEST- FIELD ACTIVITY <br /> Onsite Service Technician: Engel Molina ICC Service Tech/Installer Exp. Date: 06/23/2024 <br /> Manufacturer training: NOV, 04/26/24 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the following inspections: <br /> -Witnessed primary piping soap test of all piping joints and penetrations( product,vapor recovery and vent)and one hour <br /> pneumatic pressure test at 40psi operating pressure-All passed. <br /> *This facility is not approve to receive fuel in the tanks additional inspections are required. Refer to the approval letter dated <br /> June 28, 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: Name and Title: E Mail report to:Raja Chandi, Owner. <br /> EH Specialist: PAUL NSO Phone: (209)616-3049 <br /> SR0083410 SC298 10/10/2023 <br /> EHD 23-01 Rev.07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />