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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: 07/12/2023 <br /> Address: 18201 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: Rick Swengel ICC Service Tech/Installer Exp. Date: 07/28/2024 <br /> Manufacturer training: Modern Welding, 12/14/25 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> On site for the installation (tank set)of new Underground storage tanks: <br /> -25,000 gallon Modern Welding double-walled steel tank <br /> -12,000 gallon/8,000 gallon Modern Welding double-walled steel split tank <br /> -Verified UL labeling on all tanks and shipment papers. <br /> -Inspected tanks for lost of vacuum. No observed damages or vacuum drops on all tanks. <br /> -Inside of tank was inspected by the contractor on site(Rick Swengel)and stated to be clean and free of damages. <br /> -Verified the use of the manufacturer installation checklist at the time of inspection. <br /> -Verified tank pit, 16.5 feet deep with 12-16inches pea gravel at the bottom of the excavation. <br /> -Verified presence of deadmen and use of anchor straps. <br /> -witnessed the application of corrosion protection on all metal anchor components. <br /> -Verified use of proper pea gravel for backfilling <br /> -Witnessed initial backfilling with pea gravel.*This facility is not approve to operate the UST system. <br /> **Additional inspections are required. Refer to the approval letter dated 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 /> Vacuum gauge reading: 87 tank-20 inches Hg, 91/dsl- 19 inches Hg. <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 07/12/2023 <br /> EHD 23-01 Rev.07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />