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Appendix VI <br /> Underground Storage Tank <br /> Monitoring System Certification Form <br /> TYPE OF ACTION F7 Installation EF Repair xl 12 Month <br /> 1. FACILITY INFORMATION <br /> CERS ID Certification Date <br /> 10181299 03/04/2025 <br /> Facility Name <br /> California Stop <br /> Facility Address City ZIP Code <br /> 2224 S Manthey Rd. Stockton, CA 95206 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> E <br /> mpany Performing the Certification Phone <br /> SERVICES (707) 439-3778 <br /> Mailing Address <br /> P.O. BOX. 1299 Suisun City, CA 94585 <br /> Service Technician Performing Test <br /> Brian Dunahay <br /> Contractor/Tank Tester License Number <br /> 945643 <br /> ICC Number ICC Expiration 7Dat <br /> 8021436 05/23/2025 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Expiration Date <br /> VR#B42886 03/13/2025 <br /> LDT-890#3498 11/21/2025 <br /> M LD#3497 11/21/2025 <br /> 4. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br /> /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 is attached; and all information contained herein is accurate. <br /> Service Technician Signature Date Total # of Pages <br /> Gu�av 03/04/2025 06 <br /> CERS = California Environmental R orting 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 />