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900 S Cherokee Ln, Lodi, CA 95240 PR0231841 <br /> 10/27/2021 Program: UST <br /> PHOTO 4: <br /> The date the report was provided to the owner is before the date of inspection. <br /> MEOW <br /> Appendix XIII <br /> Desi Underground Storage Tank <br /> r Designated UST Operator Visual Inspection Report <br /> ERS ID ATION <br /> 10180627 Inspection Date 12-04-2020 <br /> Facility Name CHEROKEE ARCO <br /> Facility Address <br /> 900 S CHEROKEE LANE City ZIP Code <br /> LODI 95642 <br /> 2• DESIGNATED UST OPERATOR INFORMATION <br /> Name of Designated UST Operator <br /> Felix Ramirez Phone <br /> ICC Certification 209-744-0112 <br /> 8883072-UC Certification Expiration Date <br /> 3. COMPLIANCE ISSUES 311122 <br /> Identify by number all compliance issues listed <br /> NO TANKS OR LINE TESTING NEEDED <br /> a , <br /> c <br /> I: <br /> 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> I hereby certify that the visual inspection was performed in compliance with California Code <br /> of Regulations,title 23,division 3,chapter 16,section 2716 and all information provided <br /> herein is accurate. <br /> Designated UST Operator Signature Date Inspection Report Provided to Owner <br /> 11-06-2020 <br /> I ornia Environmental Reporting System,ICC=International Code Council,ID= <br /> p Identification, NA=Not Applicable,UDC=Under-Dispenser Containment,UST=Underground <br /> Storage Tank <br /> Page 1 of 4 <br /> VICKY VANG-LEE, EHS Page 4 of 4 <br />