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Appendix VI <br /> Underground Storage Tank <br /> Monitoring System Certification Form <br /> TYPE OF ACTION ❑Installation Repair x12 Month <br /> 1. FACILITY INFORMATION <br /> CERS ID Certification Date <br /> 10182243 03/26/2025 <br /> Facility Name <br /> Main Street ARCO AM PM <br /> Facility Address City ZIP Code <br /> 1100 S Main St Manteca 195337 <br /> 2. SERVICE TECHIS [CLAN INFORMATION <br /> Company Performinc the Certification Phone <br /> Diamond Petroleum, Services, Inc. (925)470-0803 <br /> Mailing Address <br /> 3619 King Ct Anti iv h, CA 94509 <br /> Service Technician Ferforming Test <br /> Guadalupe Sanchez <br /> roon,t-ractorlTank Tes er License Number <br /> 444 <br /> [CC Number ICC. Expiration Date <br /> 5250461 03/2212027 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Expiration Date <br /> Veeder-Root ATG Technician#A30138 09/25/2025 <br /> VMI Vaporless LDT 890 Tester#4068 06121/2025 <br /> 4. CERTIFICATIOh BY SERVICE TECHNICIAN CONDUCTING TEST <br /> 1 hereby certify tha the monitoring system is operational in accordance with California Code of <br /> Regulations, title 2 3, division 3, chapter 16, section 2638;that required supporting documentation is <br /> attached;and all ir,formation contained herein is accurate. <br /> Service Technician ignature Date Total #of Pages <br /> 03/26/2025 17 <br /> S. MONITORING SYSTEM AND PROGRAMMING <br /> CERS = California Environmental Reporting System, GPH = Gallons Per Hour, ID = Identification, <br /> ICC = Internation Code Council, LL❑ = Line Leak Detector, NA = Not Applicable, SW = Single- <br /> Walled, UDC = U der-Dispenser Containment, UST = Underground Storage Tank, <br /> VPH = Vacuum/P ssure/Hydrostatic <br /> Page 1 of 6 <br />