Laserfiche WebLink
<br />Appendix IX UE058 <br />Underground Storage Tank <br />Overfill Prevention Equipment Inspection Report Form <br />TYPE OF ACTION D Installation El Repair El 36 Month <br />FACILITY INFORMATION <br />CERS ID <br />10181547 <br />Inspection Date <br />2/2/2023 <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 Inspection <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 Inspection <br />Christopher Bogan <br />Contractor/Tank Tester License Number <br />588098 <br />ICC Number <br />9901042 <br />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 />INSPECTION PROCEDURES INFORMATION <br />Inspection Procedures Used Components Inspected <br />PEI RP1200 ATG Probe <br />CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING INSPECTION <br />I hereby certify that the OPE was inspected in accordance with California Code of <br />Regulations, title 23, division 3, chapter 16, section 2637.2; that required supporting <br />documentation is attached; and all information contained herein is accurate. I understand <br />that test procedures shall be made available upon request by the governing authority. <br />Service Technician Signature Date <br />2/2/2023 <br />Total # of Pages <br />CERS = California Environmental Reporting System, ID = Identification, ICC = International Code <br />Council, OPE = Overfill Prevention Equipment <br />Page 1 of 2