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UNDERGROUNDRTORAGETANK 1 = <br /> DESIGNATED UNDERGROUND STORAGE TANK OPS ATOR VISUAL INSPECTION REPORT F of i i r <br /> I. FACILITY INFORMATION _ a <br /> CERS ID Data of Designated UST Operator Irupecdon <br /> 10169781 01117/2020 <br /> Busrnass Name (Santo as Facirdy Name or 06A4)dny Business As ) <br /> Colonial Energy 40134 <br /> Business &rte Address Colt 21P Code <br /> 1434 Yosemite Ave Manteca CA <br /> 5337 9 <br /> �_ _ . <br /> II. DESIGNATED UNDERGROUND STORAGE TANK OPERATOR INFORMATION <br /> Nome of DeOgnated UST operator (Print as shown on the ICC Cermcation-) IIIdd <br /> phony a <br /> Carolyn ONeai_ _ (9 16) 316 - 5504 Ext. -- <br /> ICC Certification a ICC Cerhfication Ex&alion Dam A I� H 1 STORY FOF 7 <br /> 8416931 -UC 11 /22/2020 <br /> r,FY-t • - <br /> III. COMPLIANCE ISSUER t 1 : PIu a_t1iF <br /> All answer of III or 61 in sections Vit UwvWh Xl must be explairiod in this section and may ragWm rQ1f wqv wilort - — 8 rF SUMP <br /> ALI1 . Sec Vlll : L1 : Diesel STP Fuel Sum Alarm . ! FUyEL 20 a : .16 r' <br /> i � FUEL AIIII ' 5 : 5d Fri <br /> 3 . <br /> t PEC ? • 2C 19 <br /> 4. S FUEL <br /> DEC 1 . 2Ct9 10 56 EH <br /> 5. <br /> 6. <br /> 7. <br /> 8. <br /> 9. <br /> 109 <br /> M11 . Sec X : Tank tightness testing is not required. Double walled . No follow up action required , <br /> 12. Sec X: Line tightness testing is not required, Double wailed . No follow up action required, <br /> IV. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING THIS INSPECTION <br /> I hereby certify that the visual Inspection &me performed in full compliance with California Code of Regulations, tide 23, <br /> division 3, chapter 16, section 2716 and info,gnation provided herein Is accurate. <br /> Designated UST Operator signature AL ARH H 1 m ow REFORI <br /> 4; If --- -- SENSOR ALARM <br /> - - --- <br /> V. OW14ER f OPERATOR DESCRIPTION OF FOLLOW-UP ACTIONS L 2 : DIEBEL ANN <br /> Art Issue kstad in section UI above, must have a deserinfion of Pre 1010w4V action talrerr, or to be taken, to coned the Issue on the number line that SENSOR r( AL <br /> SENSOR OUT ALAt2ti <br /> corresponds MM rhe number6ne pro corroianee twue its Aslad above in section It/ OCT 3 . 2 C 19 10 : 11 YM <br /> 1 . L1 : Diesel STP fuel sump alarm Issued Isis ort 1< 198511238, company tech removed liquid , alarm cleared. FUEL ALAW <br /> OCT 3 . 2C 114 10 : 05 F+M <br /> 2. SENSOR. UUf ALARH <br /> 3, OCT 4 . 2C18 2 : 18 Fri <br /> 4. <br /> 6. <br /> 6. Nodded <br /> 7. <br /> $• k A x w x ERD <br /> 8. IN mmm, <br /> Imam <br /> 10. <br /> 11 . <br /> 12. <br /> V1, OWNER I OPERATOR ACKNOWLEDGMENT OF COMPLIANCE ISSUES <br /> 1 bars reviewed section III "COMPLIANCE ISSUES" and provided a description In section V, of the action taken or to be liken <br /> to tfsflssuesdiscovered. , siy„� 'u + r+ ISTQR� PITORr <br /> UST Ownetloperstor saltire <br /> Hama OsiswfOcwatcrtP w) 01 /17/2020 - EWOR ALiC4trt - - - - <br /> i r� f ( %r t.t> i4,e —.Vt}� _ L ocsLOV mum <br /> Fi IF a !1►tF <br /> FUEL Acta <br /> X0161 <br /> om, + 3 # 9j: i3 Iil : IQ . ►+f <br /> w� • 6rY,maltd � '�c'� -�i.. Oc r_ p F/ J <br /> -,allowN <br /> tRafJaLw <br /> i - `- ti <br /> t : � <br />