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<br />Faciii-y'�W7,e: i,00i Fcod & Liquor trspaot'sen L9rtte:(�;
<br />Facilit> :Addtess 122& Lookf®rd Street _ -W Lock. CA n5240
<br />:'.>nI4I_,ared UST Operator Conductirrgy InapeL`tio:1! r
<br />Iartsrrnptirs:tal Ct�uc Council Certificatiun No,: _ �� �� ���' � •� ! Eapinaiion Dalt:
<br />Signawe- ' - — Phone: (916) 371-2380
<br />WIIJNYJ'Vlt!�Vtir le"e`A.niEL / AL.4iRM H"'.
<br />,� �! I, m an.irrr. ystet powgir®d or, tend in pro zr o aiatr cal
<br />2. ' I� �e mofirrariu system not ocrrent siowir, ons leak alarma7 _
<br />may_. :s the Alarm lgxtory Repom/log ft,r the prev ioum almith available, and hdz
<br />;.9/tncta_a'r t>',t+ u'urm Ms'tcr repr,>"rilo,
<br />4.1taE zac,1; ola m mrrhe Vviow monis beer, Tdsponded ;o a - ro ritzreM
<br />UST SYSTEM INSPrCTION
<br />5. : Art. task -top containmw mimpa•free ofwwrat.e-, dabris, and hamrdous sub.
<br />tr, .�a, . ;. Szr,Ps tvh,r,-e an atvmr hey 0_00c�4 !ra rico- prsI r„arlh ,ma- be ;,warD;,dV%J {,''<<
<br />!moo c1,.,4,41 add w wd trig caE'a (me 4fann, .Poo ncmwl.lrm VO . to Q .' Er .,w0 ,>crvlse
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<br />...6. Ar� r iii31 btr.eke rontaitam nt structu the of µgator, d brlm, acrd t,axar
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<br />r. Ari. under-dis anser Cortaiment $reads free of watsr, ed ris axid twzardous subswl
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<br />Dis en54A^r-3/4 _...._. _ f Dis�enser-
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<br />givens:r - 7/8 _ I-Dispt�iser -
<br />?. Leak dmotion itpropet[ located Witlai►ti ander-dis .user co_htaAnment.
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<br />.rer, ic4 repFnichvl has n,r raarw�ndvd ro, and
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<br />17. Have all faei.lil jird love+e-5hired wiU.ar, Che aa5: 30 da s rapzavedthe r4 u3red on -the, ob tmirix . 7
<br />Note! JE~xplaill any "No" yard vers In the section on the _roifowing ,page. Thos- issues require corrective
<br />the UST ownertoperator,
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