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Appendix VI <br /> CBRE warts Crder#t: ' Underground Storage Tank <br /> Monitoring System Certification Form <br /> TYPE OF ACTION ©installation Repair 12 Month <br /> 7. FACILITY INFORMATION <br /> i CERS 1D 10156057 Certification Date <br /> 5/30/2025 <br /> Facility Name CASTO <br /> Facility Address 1532 N BROADWAY City STOCKTON ZIP <br /> 95205 Code <br /> -- <br /> [2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing the Certification R.L Stevens Co Phone <br /> 510-435-6249 <br /> Mailing Address P O Box 361 San Leandro, Ca. 94577 <br /> Service Technician Performing Test David Pereira <br /> Contractor/Tank Tester License Number 415807 <br /> ICC Number 5240739 IOC Expiration Date <br /> 7/18/2025 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Expiration Date <br /> Veeder Root 1/10/2026 <br /> Vaporless LDT-890 6/21/2025 <br /> 4. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br /> 1 hereby certify that the monitoring system is operational in accordance with California Code <br /> of Regulations, title 23, division 3, chapter 16, section 2638; that required supporting <br /> documentation isiattached; and all information contained herein is accurate. <br /> Servic echniciati <br /> re Date Total # of Pages <br /> 5/30/2025 <br /> CERS = California Environmental Reporting System, GPH = Gallons Per Hour, ID = Identification, <br /> ICC = International Code Council, LLD = Line Leak Detector, NA = Not Applicable, SW = Single- <br /> Walled, UDC = Under-Dispenser Containment, UST = Underground Storage Tank, <br /> VPH = Vacuum/Pressure/Hydrostatic <br /> Page 1 of 6 <br />