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Tank and Secondary Containment <br /> Assessment Document <br /> This document was prepared for : <br /> Company Name : Sanborn Chevrolet <br /> Address : 1210 S . Cherokee Lane <br /> City, California ZIP : Lodi, Ca 95240 <br /> Tank/System Identification : <br /> Used Motor Oil <br /> Date of Inspections )/Assessment : <br /> This report consists of 2-11 <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 . int <br /> -- <br /> License Number : 44590 <br /> License Type : R . C . E . fJvvr: <br /> Address of Engineer : 4. N . Main St ./ P . O . Box 611 <br /> Lodi , Ca 95240 <br /> i l sig I a. <br /> 4 g0 ; <br /> Date Stamped /Signed <br /> Sanborn Chevrolet Page 1 Used Motor Oil <br />