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Address Stockton Food & Gas, 1605 EI Dorado, Stockton CA 95206 Record ID PRO504388 <br /> Date 6/29/2022 Program: UST <br /> PHOTO 4: <br /> Over 30 days between DO inspections. <br /> W44M No <br /> N <br /> 'IMMMMM <br /> D� O q -— =4pate <br /> l0 0 pe0p lasl Appendix XIII <br /> Oj fed Underground Storage Tank <br /> N Appendix XIII 0 O 29,202 Designated UST Operator Visual Inspection Report <br /> A pato last Underground Storage Tank <br /> ga Designated UST Operator visual Inspection Report ' Oj,2a 1 LI- FACILITY INFORMATION <br /> 1.FACILITY INFORMATIOND 10182043 Inspection Date 02-11-2022 <br /> Q 21 CERS ID Inspection Date 12/17/2021 i , j 21.2 Facility Name STOCKTON FOOD AND GAS <br /> ZIP Oj, 10182043 p <br /> —2021 Facility Name STOCKTON FOOD 8 GAS 0 02.1 21 1605 S EL DORADO STOCKTON s2os atle <br /> O 07- <br /> Facility Address City ZIP Code 2,20 - _- — _— <br /> 21.20 ty 1605 S.EL DORADO STREET STOGKTON 95206 O 20 2. DESIGNATED UST OPERATOR INFORMATION <br /> O 21 <br /> 0 1 2.DESIGNATED U3T OPERATOR INFORMATION Name of Designated UST Operator Phone <br /> 2-2�2p2 O Felix Ramirez 209-744-0112 -- <br /> 4 01 NameEof Designated UST Operator Phone ICC Certification dward Steams 209 744-0112 - I O Certification Expiration Date <br /> 8883072-UC 311/2022 <br /> ICC Certification Certification Expiration Date 3. COMPLIANCE ISSUES <br /> 88830a0-UC 1212712022 <br /> 3. COMPLIANCE ISSUES Q Itlentifybynumberallcomplianceissuealisted <br /> Identify by number all compliance issues listed IQ <br /> I <br /> ✓ Yss No <br /> Yas =;I J1 <br /> Ity - No <br /> P compliance <br /> 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION -- I hereby certify that the visual inspection was performed in compliance with California Code <br /> 1 hereby certify that the visual inspection was performed in compliance with California Code of herein Regul ti os,tiittle 23,division 3,chapter 16,section 2716 and all information provided <br /> of Regulations,title 23,division 3,chapter 16,section 2716 and all information provided <br /> herein is accurate. Designated UST Operator Signature Date Inspection Report Provided to Owner <br /> Designated UST Operator Signature Date Inspection Report Provided to Owner 02-11-2022 <br /> 12/17/2021 - CERS=California Environmental Reporting System,ICC=International Code Council,ID= <br /> j Identification,NA Not Applicable,UDC=Under-Dispenser Containment,UST=Underground <br /> Identification,NA California Not Applicable,UDC ReportingEnvironmental International Code <br /> Conte nment UST Council,Underground Storage Tank <br /> Storage Tank <br /> iPage 1 of 4 <br /> Page 1 of 4 page <br /> '0°l4 -- <br /> ion 3' - <br /> page b°I ---- <br /> w <br /> Gabriela Garcia-Mejia, EHS Page 4 of 5 <br />