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Address Knife River Construction, 655 W. Clay, Stockton CA 95206 Record ID PR0231065 <br /> Date 7/20/2022 Program: UST <br /> PHOTO 2: <br /> New DO began doing inspections on 4/25/22. EHD not notified within 30 days. <br /> DO ins ections were done on the outdated DO form. <br /> k <br /> _.I <br /> GE TANK <br /> DESIGNATED UND UNDERGROUNDSTTORVI$UAI I USrOPeatorinspe�lon <br /> ERGROUND STORAGE TANK OPE ATION fpesignated <br /> CERS ID pgCILITY INFORM Date o <br /> 10181319 I' 04/25/22 <br /> Business Name ZIP Code <br /> (San ame as Fecility Nam&or DBA-Doing Business As.. 95206 <br /> DSS CS,m Address city <br /> 655 W Cla Street Stockton TOR INFORMATION <br /> Nam / DESIGNATED UNDERGROUND STORAGE TANK OPERA phone#e of Designated UST Operator(Print as shown on the ICC Certification.) (209) <br /> 948-0302 Ext. <br /> Patrick OneilI Casey ration Date <br /> ICC Certification# ICC Certification Expi <br /> 10169755 4/18/2024 <br /> III. COMPLIANCE ISSUES re u re/ollow-up action. PS <br /> All answer o/"N"or"NA"in sections vll through Xl must be explained in this section and may g INTERED SUMPS.ALL SUM <br /> 1.ALARMS THIS MONTH WHERE DO TO HEAVY DOWN POUR.WATER <br /> WHERE DRIED AFTER STORM <br /> 2. <br /> 3. <br /> 4.I <br /> 5. <br /> 6. <br /> 7. <br /> 8. <br /> 9. <br /> 10. <br /> 11. <br /> 12. <br /> IV. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING THIS INSPECTION <br /> i I hereby certify that the visual inspection was performed in full compliance with California Code of Regulations,title 23, <br /> division 3,chapter 16,section 2716 and all the information provided herein is accurate. <br /> � Designated Operator Sign re <br /> 2S_z2 <br /> V. OWN /OPERATOR DESCRIPTION OF FOLLOW-UP ACTIONS <br /> All issue listed in section 111 above,must have a descripa'on or the/allow-up action taken,or to be taken,to correct the issue on the number line that <br /> corresponds with the number line the compliance issue is listed above in section Ill. <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> 6. <br /> 7. <br /> 8. <br /> 9. <br /> 10. <br /> 11. <br /> 112. <br /> VI. OWNER/OPERATOR ACKNOWLEDGMENT OF COMPLIANCE ISSUES <br /> I have reviewed section III"COMPLIANCE ISSUES"and provided a description in section V,of the action taken or to be taken <br /> to correct the issues discovered. UST Own rr:/opera r Signature <br /> Name of UST owner/Operator(Print) Date Date Signed <br /> ? A0 — r't <br /> ID=1derAtfi UST=Underwoundtan ICC=lntartagorty <br /> CERS=CaliforVa Ervinonrnenfal ColnrA <br /> Gabriela Garcia-Mejia, EHS Page 2 of 2 <br />