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Aboveground Storage Tank Assessment Certification <br /> QUALITY FLEET SERVICE CENTER <br /> VAN DE POL ENTERPRISES, INC. <br /> 4899 South Airport Way, Stockton, California <br /> This document was prepared for: Mr. Joe Smith <br /> Company name: QUALITY FLEET SERVICE CENTER <br /> Address: 4899 South Airport Way, <br /> Stockton, California <br /> Tank/system identification: Waste Oil Tank <br /> Date of inspection(s)/assessment: 12 February 2016 <br /> Inspector name William Little <br /> This report consists of 6 pages (not including Cover sheet, Table of <br /> Contents, Figures, Tables and Appendices) <br /> I certify under penalty of law that this document and all attachments were prepared under my direction <br /> or supervision in accordance with a system designed to assure that qualified personnel properly gather <br /> and evaluate the information submitted. Based on my inquiry of the person or persons who manage the <br /> system, or those persons directly responsible for gathering the information, the information submitted <br /> is, to be the best of my knowledge and belief, true, accurate, and complete. I am aware that there are <br /> significant penalties for submitting false information, including the possibility of fine and imprisonment <br /> for knowing violations. <br /> William VanDerWall l <br /> Engineer's name Signature <br /> C 62560 Q�pFESS/0' <br /> License Number tv �,\4ANO'c� <br /> 31 December 2017 C/3 <br /> 9ryy <br /> m <br /> License Expiration C 62560 m <br /> Professional Civil Engineer <br /> it <br /> License Type F CF IVIL <br /> CA``�o���� <br /> 3720 Main Street <br /> Address of engineer <br /> Kelseyvilie, CA 95421 <br /> City,State Zip <br /> William Little <br /> i <br /> Inspector Name(If supervised by above) Signature <br />