Laserfiche WebLink
Appendix XIII <br /> Underground Storage TankectionReport <br /> Designated UST Operator Visual Insp <br /> 1. FACILITY INFORMATION Inspection Date 03/28/2023 <br /> CERS ID 10830655 <br /> Facility Name Adelfos AM PM ZIP Code <br /> Clty 95205 <br /> Facility Address Stockton <br /> 3443 Cherokee Road <br /> 2. DESIGNATED UST OPERATOR INFORMATION Phone r <br /> Name of Designated UST Operator (949)460-5200 <br /> Gabriel Martin Certification Expiration Date <br /> ICC Certification 4/26/2024 <br /> 8260320 <br /> 3. COMPLIANCE ISSUES <br /> i� <br /> j <br /> I <br /> i <br /> 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> I hereby certify that the visual inspection was performed in compliance with California Code <br /> of Regulations, title 23, division 3, chapter 16, section 2716 and all information provided <br /> herein is accurate. <br /> Designated U T erato Si re Date Inspection Report Provided to Owner <br /> 03/28/2023 <br /> CERS = California Environmental Reporting System, ICC = International Code Council, ID = <br /> Identification, NA = Not Applicable, UDC = Under-Dispenser Containment, UST = Underground <br /> Storage Tank <br /> Page 1 of 4 <br />