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S':• <br /> Appendix XIII <br /> peri <br /> Underground Storage Tank <br /> gnated UST Operator Visual Inspection Report <br /> CERS1• FACILITY INFORMATI <br /> ID ON <br /> 10182099 <br /> Facility Name Inspection Date 7/14/23 <br /> i Stockton Mobil#2 Main <br /> Facility Address <br /> Zip <br /> 3440 East Main Street city Stockton 95205 de <br /> 2 DESIGNATED UST OPERATOR INFORMATION <br /> Name of Designated UST O <br /> Ashley Nimmo Aerator Phone <br /> ICC Certification 209-744-0112 <br /> 10317263-UC Certification Expiration Date <br /> 3. COMPLIANCE ISSUES 6/27/25 <br /> /dentify by number <br /> all comp//ance issues listed <br /> l <br /> i <br /> 4. CERTIFICATION 13Y DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> 1 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 /> Desi Hated UST Operator Signature <br /> Date Inspection Report Provided to Owner <br /> 7/14/23 <br /> CERS = California Environmental Reporting System, ICC = International Code Council <br /> Identification, NA = Not Applicable, UDC = Under-Dispenser Containment, UST = U ID = <br /> Storage Tank ID <br /> page 1of4 <br />