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SAN J O A U I Environmental Health Department <br /> COUNTY <br /> Grrarness grows hare, <br /> Service Request Inspection Report <br /> Name of Facility: CHEVRON STATION#210997 Date: 06/26/2024 <br /> Address: 1442 W COLONY RD , RIPON 95366 <br /> Requestor: DAVID LASKY, WAYNE PERRY, INC Telephone: (714)826-0352 <br /> Program Element: 2303- UST/PIPING INSTALLATION Request#: SR0087169 <br /> Inspection Type: 4297- UST RETROFIT REPAIR INSPECTION <br /> Onsite Service Technician: Brandon Smith ICC Service Tech/Installer Exp. Date: 12/27/2025 <br /> Manufacturer training: NOV, 04/16/27; Bravo, 03/22/27 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> NOTES <br /> Onsite for secondary pipe testing and sump integrity testing. <br /> -Witnessed soap testing of all piping,joints, and penetrations <br /> -Witnessed secondary pipe pressure testing per manufacturer's guidelines <br /> -Verified all piping setbacks, cross-overs, and burial depth <br /> -Witnessed integrity testing of all tank sumps, vent sump, and under dispenser containment sumps <br /> All tested components passed. <br /> The facility still has additional required inspections that need to be completed. Refer to the SR0087169 approval letter for the <br /> required inspections. Provide a 48 hour notice to the Environmental Health Department(EHD)by emailing ust@sjgov.org. <br /> To minimize person to person contact the EHD is choosing to write the name of 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: Chris Brown, Prosect Manager <br /> EH Specialist: VICKY VANG-LEE Phone: (209)616-3028 <br /> FA0013918 SR0087169 SC4297 06/26/2024 <br /> EHD Rev.09/16/2020 Page 1 of 1 Service Request Inspection Report <br />