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MODEL <br /> Tank and Secondary Containment <br /> Assessment Document <br /> This document was prepared for: <br /> Company Name: Tracy Material Recovery Facility <br /> Address: 30703 S. MacArthur Dr. <br /> City, California ZIP: Tracy, CA <br /> Tank/system identification: Used Motor Oil <br /> Date of Inspection(s)/Assessment: <br /> 12/3/2018 <br /> This report consists of 20 pages, Including 4 attachments <br /> I certify under penalty of law that this document and all attachments were prepared under my <br /> direction or supervision in accordance with a system designed to assure that qualified personnel <br /> properly gather and evaluate the information submitted. Based on my inquiry of the person or <br /> persons who manage the system, or those persons directly responsible for gathering the <br /> information, the information submitted is,to be the best of my knowledge and belief,true, <br /> accurate, and complete. I am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment for knowing violations. <br /> Engineer's Name: Mike Smith Engineering, Inc. ;; <br /> License Number: 44590 r � <br /> License Type: R.C.E. ." 2 <br /> Address of Engineer: 4. N. Main St./P.O. Box 611 <br /> Lodi, Ca 95240 <br /> Date Stamped/Signed <br /> Tracy Material Recovery Facility Tank/Tank System Identification: Used Motor Oil <br />