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Tank and Secondary Containment <br /> Assessment Document <br /> This document was prepared for: <br /> Kia Country <br /> 1515 N. Main Street <br /> Manteca, CA 95336 <br /> Tank/system identification: <br /> Waste Oil Storage Tank and Conveyance System <br /> Date of inspections)/assessment: <br /> July 3, 2018 <br /> This report consists of 12 pages. <br /> I certify under penalty of law that this document and all attachments were prepared under my <br /> direction or supervision in accordance with a system designed to assure that qualified <br /> personnel property gather and evaluate the information submitted. Based on my inquiry of the <br /> person or persons who manage the system,or those persons directly responsible for gathering <br /> he information,the information submitted is, to be the best of my knowledge and belief, true, <br /> ccurate, and complete. I am aware that there are significant penalties for submitting false <br /> information, Including the possibility of fine and imprisonment for knowing violations. <br /> Engineer's name: Jeffrey K. Belwood, Robert F. Martin <br /> License Number: M-29705, C-53437 <br /> License Type: Mechanical, Civil <br /> ddress of engineer: PO Box 9384, Stockton, CA 95208, 623 Baker Dr. Ripon <br /> CA 95366 <br /> -' paOFESSrp,� - -. <br /> SEI K. a �Ey OQ ,()LI s/ .nom <br /> yp00 <br /> it 297 05 0. C 431 _ t] <br /> Ex . 6 3o zo Exp, <br /> y�sf�T`'f�HANVCP� CNlk- <br /> �OF c� mor CAl1F�� <br /> Date stam ed/si 4: Julv 9, 2018 <br /> 1 <br />