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SAN JOAOUIN <br />COUNTY <br />Greotr+ess grows here. <br />Environmental Health Department <br />Underground Storage Tank Program Service Request Inspection Report <br />Name of Facility: SAFEWAY FUEL CENTER #1769 <br />Date: 04/04/2024 <br />Address: 2802 COUNTRY CLUB BLVD, STOCKTON 95204 <br />Requestor: RYAN BROWNLEE - CONTRACTOR, ALBE MAINTENANCE INC <br />Telephone: (707) 569-4791 <br />Program Element: 2308 - UST RETROFIT <br />Request #: SR0086810 <br />Inspection Type: 298 - UST SERVICE REQUEST - FIELD ACTIVITY <br />Onsite Service Technician: Stephan Ingrham <br />ICC Service Tech/Installer Exp. Date: 03/24/2026 <br />Manufacturer training: FF, 05/24/24; VR, 07/19/24; VMI, 07/28/24 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />NOTES <br />On site for the following: <br />- Witnessed monitoring system functionality testing. Passed. <br />- Witnessed the one hour hydrostatic test of the spill containment for the 87, 91, and diesel. Passed. <br />- Witnessed leak detector testing. Passed. <br />- Verification of overfill prevention for the product 87, 91, and diesel. Passed. <br />This facility is APPROVED to operate. <br />*******NOTE****** <br />This facility annual Monitoring System Certification have been reset to April. <br />To minimize person to person contact EHD is choosing to write the name of the pers on 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: <br />EH Specialist: KRISTINA SAETERN <br />Name and Title: Emailed to Keith Power, Environment <br />Phone: (209) 616-3045 <br />FA0012764 SR0086810 SC298 04/04/2024 <br />EHD 23-01 Rev. 07/05/2022 Page 1 of 1 Underground Storage Tank Program Service Request Inspection Report <br />