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A <br /> Appendix XIII <br /> Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> [TI _FACII7,;Y INFORMATION - -- --- --- _ ----- — <br /> CERS ID 10180839 Inspection Date 3/10/2023 <br /> F lity Name -- - -- <br /> DINO MART - MONTEREY FUELS <br /> Facility Address 19 ZIP Code <br /> 01 S. E=L DORADO ST YSTOCKTON , <br /> 2: DESIGNATED UST OPERATOR INFORMATION <br /> Name of Dasi!gnated UST Operator Phone <br /> Edward Steams 209-744-0112 <br /> ICC Certftation Certification Expiration Date <br /> 8883080-UC 3/3/2024 <br /> 3. COMPLJANCE ISSUES <br /> Identify by number all compliance issues listed <br /> I <br /> 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> 1 hereby certify that the ASUal 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 /> t}ST Operator Sicinature bate Inspection Report Pro�rided to-- <br /> nec <br /> Designated 3/1 Q/�023 <br /> CF-RS = Califomia Environmental Reporting System, ICC = International Code Council ID L <br /> Ident tion, NA = Not Applicable, UDC = Under-Dispenser Containment, UST - Underground <br /> Storage Tank <br />