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Appendix XIII <br /> Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 1. FACILITY INFORMATION <br /> CERS ID 10184725 Inspection Date 10/12/2024 <br /> Facility Name West Valley Auto Service LLC <br /> Facility Address City ZIP Code <br /> 2615 W Grant Line RD Tracy 95304 <br /> 2. DESIGNATED UST OPERATOR INFORMATION <br /> F <br /> Name of Designated UST Operator Phone <br /> Rick Branchini (925) 699-1396 <br /> [CC Certification Certification Expiration Date <br /> 8164986 6/18/2026 <br /> 3. COMPLIANCE ISSUES <br /> GVR TLS-350 AFN <br /> System Not in alarm at time of inspection <br /> Weather Conditions: Clear and Dry <br /> Spill Buckets: Clean of Debris Slight Liquid <br /> Still awaiting the SB-989 repairs as per previous test failures <br /> High Liquid L-4 9/28, 10/4 self cleared NFA <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 Signature Date Inspection Report Provided to Owner <br /> Rick Branchini Digitally signed by Rick Branchini <br /> Date:2024.10.22 08:52:46-07'00' 10/12/2024 <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-111 www.unidocs.org Rev.10/01/20 Page 1 of 4 <br />