Laserfiche WebLink
<br />Appendix VI <br />UE058 <br />Underground Storage Tank <br />Monitoring System Certification Form <br />TYPE OF ACTION <br /> <br />El Installation 0 Repair 12 Month <br />FACILITY INFORMATION <br />CERS ID <br />10181547 <br />Certification Date <br />02/02/2023 <br />Facility Name <br />Pacific Bell Telephone Co. dba AT&T California <br />Facility Address <br />10 E. 12th St. <br />City <br />Tracy <br />ZIP Code <br />95376 <br />SERVICE TECHNICIAN INFORMATION <br />Company Performing the Certification <br />TAIT Environmental Services, Inc. <br />Phone <br />(714) 560-8222 <br />Mailing Address <br />11280 Trade Center Dr., Rancho Cordova, CA 95742 <br />Service Technician Performing Test <br />Christopher Bogan <br />Contractor/Tank Tester License Number <br />588098 <br />ICC Number <br />9901042 <br />ICC Expiration Date <br />01/28/2025 <br />TRAINING AND CERTIFICATIONS <br />Manufacturer and Test Equipment Training Certifications Expiration Date <br />Veeder-Root - C30413 01/07/2024 <br />CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br />I hereby certify that the monitoring system is operational in accordance with California Code <br />of Regulations, title 23, division 3, chapter 16, section 2638; that required supporting <br />documentation is attached; and all information contained herein is accurate. <br />Service Technician Signature <br />..---- . <br />L- /- <br />Date <br />02/02/2023 <br />Total # of Pages <br />CERS = California Environmental Reporting System, GPH = Gallons Per Hour, ID = Identification, <br />ICC = International Code Council, LLD = Line Leak Detector, NA = Not Applicable, SW = Single- <br />Walled, UDC = Under-Dispenser Containment, UST = Underground Storage Tank, <br />VPH = Vacuum/Pressure/Hydrostatic <br />Page 1 of 6