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Appendix XIII <br /> Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 1 . FACILITY INFORMATION <br /> CERS ID 10181669 Inspection Date 0 &27 -2021 <br /> Facility Name NATIONAL PETRO YOSEMITE <br /> Facility Address City ZIP Code <br /> 2072 W YOSEMITE MANTECA 95337 <br /> 2 . DESIGNATED UST OPERATOR INFORMATION <br /> Name of Designated UST Operator Phone <br /> Felix Ramirez 209-744-0112 <br /> ICC Certification Certification Expiration Date <br /> 8883072- UC 3/ 1 /2022 <br /> 3 . COMPLIANCE ISSUES <br /> Identify by number all compliance issues listed <br /> L 9 100 OCTANE SUMP AUG 22ND FUEL ALARM <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 /> Feil Rg4mr u 08 - 27 - 2021 <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 />