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Address Pilot, 345 Roth Rd, French Camp CA 95231 Record ID PR0540987 <br /> Date 8/11/2022 Program: UST <br /> PHOTO 2: <br /> L13 (dispenser 1-2 hydro) fuel alarm on 5/9/2022 was not addressed in the DO report on 5/31/2022. <br /> Appendix XIII <br /> Desi Underground Storage Tank <br /> 1. FgCILITY INFO nated UST operator Visual Inspection Report <br /> RMATION <br /> CERS ID 10726990 <br /> Inspection Date gy <br /> Facility Name p- 31 702-2 <br /> PILOT/FI yING J TRAVEL PLAZA#1017 LATHROP <br /> Facility Address 345 ROTH ROAD City LATHROP ZIP Code <br /> 2. DESIGNATED UST OPE 95330 <br /> BATOR INFORMATION <br /> Name of Designated UST Operator <br /> UST OPERATORS OF so. CAL, INC Phone <br /> ICC Certification 949-230-8931 <br /> LANCE YORK Certification Expiration Date <br /> ICC Certification 5296385-UC AUGUST 1, 2022 <br /> KAILI JAMES Certification Expiration Date <br /> ICC Certification 8209433 SEPTEMBER 8, 2022 <br /> GARRETT JAMES Certification Expiration Date <br /> 3. COMPLIANCE ISSUES 8723071 MAY 25, 2023 <br /> Identify by number all compliance issues listed <br /> 1. `�tklP�o>/EC Tit tJ tf Y N'r✓�A�� <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> 6. <br /> 7. <br /> 8. <br /> 9. <br /> 10. <br /> 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> I hereby certify that the visual inspection was performed in compliance with California Code of <br /> Regulations,title 23,division 3,chapter 16,section 2716 and all information provided herein is accurate. <br /> Designated UST Operator:Na e&Signat Date Inspection Report Provided to Owner <br /> LANCE YORK tMR 3l 2o2'j� <br /> CERS=California Environmenta eporting System,ICC=International Code Council,ID=Identification, <br /> NA=Not Applicable,UDC=Under-Dispenser Containment,UST=Underground Storaqe Tank Pace 1 of 4 <br /> Gabriela Garcia-Mejia, EHS Page 2 of 2 <br />