Laserfiche WebLink
Appendix XIII nk <br /> Underground Storage T, ection Report <br /> 4' Designated UST Operator Visual Insp <br /> 1 FACILITY INFORMATION <br /> CERS !D 10180717 Inspection Date 3/7/2022 <br /> Facility Name <br /> Chevron ZIP Code <br /> Facility Address City 95212 <br /> 10878 N HWY 99 Stockton <br /> 2. DESIGNATED UST OPERATOR INFORMATION <br /> Name of Designated UST Operator Phone (916) 704-6948 <br /> Adam Smitheram Certification Expiration Date <br /> ICC Certification <br /> 9084899 1/22/2023 <br /> 3. COMPLIANCE ISSUES <br /> SO#2110259 <br /> Monitor States: All Functions Normal <br /> - Site has no alarm history <br /> No issues at site <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 /> Designa U Oper tar at _ Date Inspection Report Provided to Owner <br /> 3/7/2022 <br /> CERS = California Envi nmental 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 />