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TANK CLOSURE Cali TIFICATIGN FORM <br />auvr.Ess..Auc <br />a <br />:AcuTv w. + <br />Diesel Performance, Inc. <br />,a <br />2900 E. Fremont St. <br />3 ,Neas QT. <br />Stockton CA <br />16S ausaass as 95205 roe <br />T, CVMER a a <br />SM <br />Diesel Performance, Inc. <br />TA""c""'OOX 2804 E. Fremont St. <br />P. 0. Box 8387 <br />i <br />fol <br />STAT folaP <br />Sw <br />TMKZMIEIR CTY <br />Stockton <br />CA <br />195208-0387 <br />FI <br />Tank S 1 <br />Plammaole Vapor CKygen <br />Too <br />Cantef Bottom Too <br />Center <br />Satrom <br />(Slate Tank ICS. if 3pp+ieadle) <br />Tank Interior <br />Ise 0 <br />Reaaings <br />OtiOO <br />I <br />I <br />_ / ; <br />d n'J <br />®C70f <br />Li% GO <br />On examination of the tank. I certify the tank is visualty free from product sludge. scale <br />(thin, flaky residual of tank contents), nnseate and (leans. I termer cerMY <br />that the information provwed In tN ac=rate (G)he deal of my knowledge. <br />fcs <br />CERTIFIERSIGNATURE dh=o <br />STATUS OR AFFILIA-nCN OF CEiTIP nNG PSRSCN <br />Cartifier is a representative of the CUFA/UA: YES Q IVO Q <br />i <br />Name of CUPAIUA <br />If renfier Is other than CUPAJA We= appropriate twx oelpw: <br />Q carolled Industrial Nygenist(C,M) <br />Q Certified Safety (CSP) <br />CERTIFIER NAME (PRIN Martin a <br />CERTIFIER TITL stir <br />Contractor <br />ACCRESS P. 0. Box 357 <br />Carr Lodi CA 95241-0357 <br />PMONE362-6175 <br />_ <br />DATE CERTIFIED soe CERTIFICATION TIME <br />ChemisPtafessit <br />Cmtrfied Morose Chamtct (GNC) <br />Registered Errvironmewl Neauh Speaat(st (REQS) <br />Q Prnfessipnal Engineer (pe <br />Q Crass II Registered Erluvanmerrol Assessor <br />Q CSl9 tkumsed contras: I (with ftlardous wostai carmlgte) a <br />This tank pre,nousty, held iammaale or cemousaale matenaLv. <br />[Z Yes Q No <br />It yes, the wK interior atmpsptsete shall be rn-Ctedwd w(lSt a oamcusdble gas <br />indloator prior to work being conducted on the tank <br />Cariifiers tank management instructions for strap dealer. disposal fatality, eta <br />A copy of this cenlfinte shall acramcany me tank to the recycing(disoosal fatality. <br />