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Aboveground Storage Tank Assessment Certification <br />QUALITY FLEET SERVICE CENTER <br />VAN DE POL ENTERPRISES, INC. <br />4899 South Airport Way, Stockton, California <br />This document was prepared for: <br />Mr. Joe Smith <br />Company name: <br />i <br />QUALITY FLEET SERVICE CENTER <br />Address: <br />4899 South Airport Way, <br />Stockton, California <br />Tank/system identification: <br />Waste Oil Tank <br />Date of inspections)/assessment; <br />12 February 2016 <br />Inspector name <br />i <br />William Little <br />This report consists of <br />6 pages (not including Cover sheet, Table of <br />Contents, Figures, Tables and Appendices) <br />I certify under penalty of law that this document and all attachments were prepared under my direction <br />or supervision in accordance with a system designed to assure that qualified personnel properly gather <br />and evaluate the information submitted. Based on my inquiry of the person or persons who manage the <br />system, or those persons directly responsible for gathering the information, the information submitted <br />is, to be the best of my knowledge and belief, true, accurate, and complete. I am aware that there are <br />significant penalties for submitting false information, including the possibility of fine and imprisonment <br />for knowing violations. <br />William VanDerWall <br />QpofESS/p <br />�Q���Ql� 4AND,c <br />Engineer's name Signature <br />C 62560 <br />License Number <br />31 December 2017 <br />z <br />C 62560 m <br />�r <br />TFOFICA�-�FC��\� <br />License Expiration <br />Professional Civil Engineer <br />License Type <br />3720 Main Street <br />Address of engineer <br />Kelseyville, CA 95421 <br />City, State Zip <br />William Little <br />Inspector Name (If supervised by above) Signature <br />