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rays <br /> ,ts= 4 '* <br /> Page 1 of 4 <br /> e�Q-ianK <br /> 'Cfor Visual Inspection Report <br /> OBs/9�ated U <br /> !. FAC/L/TY/A, -0O 11 <br /> Pj <br /> CER-t; 1� 10844113Inspection Date <br /> 11/30/22 <br /> Facility Name Harney Lane 76 <br /> 1Facility Address City <br /> 141 Lodi E. Harney Lane I ZIP Code <br /> 2. DESIGNATED UST OPERATOR INFORMATION 95240 <br /> Name of Designated UST Operator <br /> Alex Jabbari Phone 925-389-1262 <br /> ICC Certification <br /> 5243897-UC Certification Expiration Date <br /> 8118/24 <br /> 3. COMPLIANCE ISSUES <br /> L16: Vents Brine alarm on 10/27 cleared by itself <br /> 124: U DC 7/8 Brine alarms on 10/24, 11/26 and 11/27 cleared by itself <br /> L28: UDC 11/12 Brine alarms on 10/28, 11/30 and 11/3 cleared by itself <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 Si atur Date Inspection Report Provided to Owner <br /> X // 30 zz <br /> CERS = California Environmental Reporting System, ICC = International Code Council, ID = <br /> Identification, NA = Not Applicable, UDC = Under-Dispenser Containment, UST = Underground <br /> Storage Tank <br /> UN-1II www.unidocs.org Rev.10101120 Page 1 of 4 <br />