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Designated U action RePO t <br /> SON 1• FACILITY INFORMATION WI437WILSONWAY CHEVRON <br /> WILSON WAY <br /> CERS ID STOCKTON, CA.95205 <br /> 10181299 209-942-2344 Jction Date 12/2/22 <br /> Facility Name DEC 2, 2022 4:06 PM <br /> WilsonWay Che <br /> [Facility <br /> S.STEM STATuS REPORT ZIP Code <br /> - - - - 95205 <br /> ALL FUNCTION~ NORMAL On <br /> F2. DESIGNATED UST OPERATC <br /> Name of Designated UST Operatc lone <br /> Alex Jabbari 25. 89.1262 <br /> ICC Certification srtification Expiration]D]ae <br /> 5243897-UC ALARM HISTORY REPORT 18/24 <br /> 3. COMPLIANCE ISSUES ----- SENSOR ALARM ----- <br /> L 1 :PEG ANNULAR <br /> NO alarms and compliance isSUeS FUELLAR ALARPACE <br /> FEB 8. 2022 6:32 PM <br /> FUEL ALARM <br /> FEB 0, 2022 11 : 15 AM <br /> FUEL ALARM <br /> FEB 0, 2022 11 : 17 AM <br /> { <br /> t <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 UST Operator Signature <br /> Date Inspection Report Provided to Owner <br /> ERS = California Environmental Reporting System, ICC = International Cod <br /> entification, NA = Not Applicable, UDC = Under-Dispenser Containment e Council, Ip <br /> Forage Tank , UST = Underground <br /> 1AAA/ <br />