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Appendix XIII <br /> Underground ;storage Tank <br /> Report <br /> Designated UST Operator Visual Inspection <br /> 1. FACILITY INFORMATION <br /> Inspec <br /> tion Date 5/4/2023 <br /> CERS ID 10180839 <br /> Facility Name DINO MART - MONTEREY FUELS ZIP Code <br /> C►ty STCCKTON 95206 <br /> Facili Address 1901 S. IEL DORADO ST <br /> 2. DESIGNATED UST OPERATOR INFORMATION <br /> Name of Designated UST Operator Phone <br /> Edward Stearns <br /> Certification Expiration Date <br /> ICC Certification 3/3/2024 <br /> 8883080-LJC <br /> 3. COMPLIANCE ISSUES <br /> Identify by number al/compliance issues listed <br /> 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> 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 Siqnature Date Inspection Report Provided to Owner <br /> --- 5/4/2023 <br /> CERS = California Environmental Reporting System, ICC = International Code Council, ID = <br /> Identification, NA = Not Applicable, UDC = Under-Dispenser Containment, UST = Underground <br /> Storage "Fank <br /> Page 1 of 4 <br />