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Appendix IX <br />,,A -A71 Al <br />Underground Storage Tank <br />Overfill Prevention Equipment Inspection Report Form <br />TYPE OF ACTION ❑ Installation ❑x Repair ❑ 36 Month <br />1. FACILITY INFORMATION <br />CERS ID <br />10141507 <br />Inspection Date <br />2024-07-09 <br />Facility Name <br />Manteca CO <br />Facility Address <br />430 W Center St <br />City <br />Manteca <br />ZIP Code <br />95336 <br />2. SERVICE TECHNICIAN INFORMATION <br />Company Performing the Inspection <br />SunWest Engineering Constructors, Inc <br />Phone <br />(888) 588-8737 <br />Mailing Address <br />4780 Cheyenne Way, Chino CA 91710 <br />Service Technician Performing Inspection <br />Kraig Kinder <br />Contractor/Tank Tester License Number <br />703190 <br />ICC Number <br />8296393 <br />Expiration Date <br />2024-11-10 <br />3. TRAINING AND CERTIFICATIONS <br />Manufacturer and Test Equipment Training Certifications <br />Expiration Date <br />Veeder Root <br />04/11/2026 <br />4. INSPECTION PROCEDURES INFORMATION <br />Inspection Procedures Used <br />Components Inspected <br />PEI/RP 1200 <br />Automatic Tank Gauge <br />5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING INSPECTION <br />I hereby certify that the OPE was inspected in accordance with California Code of <br />Regulations, title 23, division 3, chapter 16, section 2637.2; that required supporting <br />documentation is attached; and all information contained herein is accurate. 1 understand <br />that test procedures shall be made available upon request by the governing authority. <br />Service Technician Signature <br />�'�i <br />Date <br />2024-07-09 <br />Total # of Pages <br />8 <br />CERS = California Environmental Reporting System, ID = Identification, ICC = International Code <br />Council, OPE = Overfill Prevention Equipment <br />Page 1 of 8 <br />