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Appendix IX <br /> Underground Storage Tank <br /> Overfill Prevention Equipment Inspection Report Form <br /> TYPE OF ACTION ❑ Installation ❑ Repair ❑ 36 Month <br /> 1. FACILITY INFORMATION <br /> CERS ID 10180717 Inspection Date <br /> 10/13/2025 <br /> Facility Name FAST & EASY #60 <br /> Facility Address 10878 N HWY 99 City STOCKTON ZIP Code <br /> 95212 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing the Inspection Phone <br /> Eco-Chek Compliance, Inc. 880-500-3435 <br /> Mailing Address PO Box 1394 Lafayette, CA 94549 <br /> Service Technician Performing Inspection <br /> Erik Hinojosa <br /> Contractor/Tank Tester License Number958763 A <br /> ICC Number Expiration Date <br /> 9209377-UT 05/07/2026 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Expiration Date <br /> FF- EBW , Phil-Tite & EVR Phase 1 2579653717 09/17/2027 <br /> ATG: VR C37324 08/26/2026 <br /> 1194098 02/27/2027 <br /> 4. INSPECTION PROCEDURES INFORMATION <br /> Inspection Procedures Used Components Inspected <br /> MANUFACTUR OVERFILL VALVES <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. I understand <br /> that test procedures shall be made available upon request by the governing authority. <br /> Service Technician Signature Date Total # of Pages <br /> 10/13/2025 9 <br /> CERS = California Environmental Reporting System, ID = Identification, ICC = International Code <br /> Council, OPE = Overfill Prevention Equipment <br /> Page 1 of 2 <br />