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UNDERGROUND STORAGE TANK <br /> FDESIGNATED UNDERGROUND STORAGE TANK OPERATOR VISUAL INSPECTION REPORT (Page t of 2) <br /> I. FACILITY INFORMATION <br /> � of Designated UST Operator Inspection <br /> Date <br /> 10181441 1/16/2020 <br /> Husiness Name(Same as Facility Name or DBA-Doing Business As) <br /> RIVERPOINT MARINA <br /> Business Site Address City ZIP Code <br /> 4950 BUCKLEY COVE WAY I STOCKTON CA 195267 <br /> II, j DESIGNATED UNDERGROUND STORAGE TANK OPERATOR INFORMATION, <br /> Name of Designated UST Operator(Print as shown on the/CC Certification.) Phone# <br /> David Winkler (209) 744-0112 <br /> !CC Certification# ICC Certification Expiration Date <br /> 8883059—UC 2/23/2020 <br /> III. COMPLIANCE ISSUES.,' <br /> All answers of"N"or WA"in sections V11 through X1 must be explained in this section and may require follow-up action. <br /> 1. NO ALARMS TO REPORT <br /> 2. <br /> --3. — – <br /> 4. <br /> 5. T <br /> 6. <br /> 9. <br /> 10. SECTION VII NO PRINTER ON ATG <br /> 19. _ <br /> 12. SECTION X NO TANK TESTING NEEDED SITE HAS DOUBLE WALL TANKS <br /> I hereby certify that ithe visual inspection was performed In full compliance with California Code of Regulations, Title 23, <br /> Division 3,Chapter 16,Section 2716 and all the information provided herein is accurate. <br /> Designated UST Operator Signature <br /> V. 0WN -PPE-ERATO!,LIES E_ P'EIpA� F _ ` 0 19 r A l <br /> All issues listed in Section 111 above must have a description of the follow-up action taken or to be taken to correct the issue on the number <br /> line that corresponds with the number line of the compliance issue listed above in Section 111. <br /> 1. 61 <br /> 2. <br /> – _. . _ <br /> 4. <br /> 5. <br /> 6. <br /> 7. cr _ <br /> 8. <br /> 9. <br /> 10. <br /> 11. <br /> 12. <br /> ', ,„gib 0 E. P , I�.AWP _ � OMPLIANCE I4SUE <br /> I have reviewed Sect on III"COMPLIANCE ISSUES” and provided a description In Section V of the action taken or to be taken <br /> to correct the Issues discovered. <br /> Name ST Owner/Operator(Print) UST Owner/O Date Si ned <br /> CERS=CaOfornia Erwironmental Reporting System,ID=Identification,UST=Urxiergrnuid Storage Tank,ICC=Internabonal Code C%rd J <br />