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Appendix XIII <br /> Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 1. FACILITY INFORMATION <br /> CERS ID 10181239 Inspection Date 11/18/2020 <br /> Facility Name A&A GAS <br /> Facility Address16 EAST HARDING WAY City STOCKTON 95204ode <br /> 2. DESIGNATED UST OPERATOR INFORMATION <br /> Name of Designated UST Operator Phone <br /> David Winkler 209-744-0112 <br /> ICC Certification Certification Expiration Date <br /> 8883059-UC 2/17/2022 <br /> 3. COMPLIANCE ISSUES <br /> Identify by number all compliance issues listed <br /> 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> I hereby certify that the visual inspection was performed in compliance with California Code <br /> of Regulations, title 23, division 3, chapter 16, section 2716 and all information provided <br /> herein is accurate. <br /> Designated UST Operator Signature Date Inspection Report Provided to Owner <br /> W 11 /18/2020 <br /> CERS = California Environmental Reporting System, ICC = International Code Council, ID = <br /> Identification, NA = Not Applicable, UDC = Under-Dispenser Containment, UST = Underground <br /> Storage Tank <br /> Page 1 of 4 <br />