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APPendix 7{III <br /> Undergtor3nd Storage Tank <br /> Designated UST 0Perator MMuaI ins <br /> 1. FAC41LXTY jNFC) NM-nON -- pection Report <br /> --- <br /> F�l <br /> R4 Karn z --- Inspection }$ <br /> CheVror� <br /> Facility Addre,5s <br /> 444 MOssdale Rd. City <br /> 2- DESIGNATFD UST Lathrop 195330 ZIP Cade <br /> PEF ATpR I QRMA-nON <br /> Marne o= Designated UST Dpera4or <br /> 1:113Z enrlce S #iorti Maintenance, Inc Phone <br /> f ertifctfon 916-371-2380 <br /> �c�tic �yp��xl0n date <br /> 4. ER"FI'DAMN BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION - <br /> I hereby certify that the visual inspection was performed in compliance with California rfc-� <br /> of Regulations, title 23. division 3. chapter 16, section 27160 and all informauon provided <br /> herein is accurate. <br /> Designated UST Operator Signature – — [date Inspection Re'Ne, Providedto 0-v:-e- <br /> } 1-7 ! <br /> I <br /> CERS = California Environmental Reporting System. ICC - International Code Council, ID;-- <br /> identification, <br /> D=identification. ISA Not Applicable, LIDO = Under-Dispenser Containment- UST = Undergro-j-id <br /> Storage Tank <br /> Page 1 o= c <br />