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j <br /> Unde Appendix XIII `'" lig►"� <br /> r t <br /> r <br /> 0 <br /> pesignated UST p g and Storage Tank <br /> Aerator Visual Inspection Report <br /> pert <br />;0643 eport <br /> InspeCtion Date <br /> luick Stop Market # 125 10/18/2021 <br /> E9/16/2021 <br /> Street City <br /> Ripon195366 <br /> ZIP Code <br /> D UST OPERATOR INFORMATION ZIP Code <br /> ited UST Operator 195366 <br /> Phone <br /> 916-372-1888 <br /> Certification Expiration Date B <br /> ISSUES 10/26/2022 Expiration Date <br /> ttached for the service call that was placed after the previous months <br /> 1 was removed from the UDC of dispenser 5-6. !r upgrade. A Work <br /> d and a service call <br /> BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION SPECTION <br /> ection was performed in compliance with California Code <br /> the visual ins section section 2716 and all information provided Nith California Code <br /> 23, division 3, chapter 16, nation provided <br /> Date Inspection Report Provided to Owner <br /> ture Ort Provided to Owner <br /> rator Signa� 10/18/2021 <br /> System, ICC = International Code Council, ID = Council, ID - <br /> ental Reportin Under_Dispenser Containment, UST = Underground - - <br /> ironm U[)C = = Underground <br /> I Applicable <br /> Page 1 of 4 <br />