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Aboveground Storage Tank Assessment Certification <br /> TERESI TRUCKING <br /> 900 % Victor Road, Lodi, California <br /> This document was prepared for: Teresi Trucking, Inc. <br /> Company name: Teresi Trucking, Inc. <br /> Address: 900 '/Victor Road, Lodi, California <br /> Tank/system identification: Waste Oil Tank <br /> Date of inspection(s)/assessment: 29 January 2019 <br /> Inspector name Rene M. Toth <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 is, <br /> 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 for <br /> knowing violations. <br /> Daya Bettadapura �riG ci E� <br /> Engineer's name Signature <br /> C46505 VF,OFESSION <br /> License Number P.BErT'f��t<`y <br /> 30 June 2019 <br /> License ExpirationNo. C04660 <br /> Professional Civil Engineer gyp' <br /> License Type CIVIL \� <br /> q ^_ � <br /> 1701 East Edinger Avenue � �- OF GALW-1I <br /> Address of engineer <br /> Santa Ana, CA 92705 <br /> City,State Zip <br /> Rene M. Toth <br /> I !?IJ-1 A <br /> Inspector Name Signat <br /> (If supervised by above) <br />