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3555 W Hammer Ln, Stockton, CA PR0231130 <br /> 04/13/2022 Program: UST <br /> PHOTO 1: <br /> The 04/16/2021 desi nated o erator(DO) inspection was perfonned more than 30 days from the previous ins ection <br /> Appendix XIII <br /> i <br /> - Underground Storage Tank o' <br /> _ Designated UST Operator Visual Inspection Report j <br /> (_r' 1. FACILITY INFORMATION -- <br /> CERS ID Inspection Date 4-16-2021 <br /> 10180893 Appendix XIII <br /> erground Storage Tank <br /> Facility Name Quick Stop Market#132 Designated UST dOperator Visual Inspection Report <br /> Facility Address CityI ZIP Code 1. FACILITY INFORMATION <br /> 3555 West Hammer Lane Stockton 95219 <br /> CERS ID 10180893 <br /> 2. DESIGNATED UST OPERATOR INFORMATION nspection Date 31612021 <br /> Facility Name Ouick Stop Market fn32 <br /> E <br /> e of Designated UST Operator Phone916-372-1888 Facility Address CityZIP Code <br /> ony Reyes 3555 West Hammer Lane Stockton 96219 <br /> Cenification Certification Expiration Date NATED UST OPERATOR INFORMATION <br /> 772 11-20-2022 <br /> 3. COMPLIANCE ISSUES Name of Designated UST Operator <br /> Phone <br /> Curtis Car enter 916-372-1888 <br /> All alarms 4-13-21 caused by annual monitoring certification. ICC Certification <br /> 8167865 Certification Expiration Date <br /> 1012612022 <br /> 3. COMPLIANCE ISSUES <br /> 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> I hereby certify that the visual inspection was performed in compliance with California Code I hereby certify that the visual inspection was performed in compliance with California G <br /> of Regulations,title 23,division 3,chapter 16,section 2716 and all information provided of Regulations,title 23,division 3,chapter 16,section 2716 and all information provided <br /> herein is accurate. herein is accurate. <br /> Designated UST Operator Signature Date Inspection Report Provided to Owner Designated UST operator Signature Date Inspection Report Provided to C <br /> uw 4-16-2021Le a 31812021 <br /> (, CERS=California Environmental Reporting System,ICC=International Code Council,ID= <br /> CERS=California Environmental Reporting System,ICC=International Code Council,ID= Identification,NA=Not Applicable,UDC=Under-Dispenser Containment,UST=Undergmur <br /> Identification,NA=Not Applicable,UDC=Under-Dispenser Containment,UST=Underground Storage Tank <br /> Storage Tank pac <br /> Page 1 of 4 <br /> VICKY VANG-LEE, REHS Page 1 of 2 <br />