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18806 N Lower Sacramento Rd, Woodbridge Record ID PR0232388 <br /> 4/26/2021 UST Inspection <br /> Photo 5: The operator of the UST system failed to sign and print their name on several reports. <br /> Underground Storage Tank <br /> Designated UST Operator Usual Inspection Report Designated <br /> RATOR DESCRIPTION OF FOLLOW-UP ACTION 1• FACILITY INFORMATION <br /> 5. OWNER/OPE <br /> CERS ID <br /> Number the follow up actions to correspond to appropriate compliance issues from Section 3. 10181237 <br /> Facility Name WOODBRIDC <br /> f=acility Address <br /> 18806 LOWI <br /> 2. DESIGNATED UST OPEF <br /> Name of Designated UST OF <br /> q <br /> Zane Nimmo <br /> ICC Certification <br /> _ 8883064-UC <br /> 3. COMPLIANCE ISSUES <br /> i <br /> Identify by number all complia <br /> °s 87 S T P SUMP ALARM. L( <br /> v <br /> F <br /> - -,:2 <br /> S. OWNER t OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br /> z� M` 1 have reviewed the results of the designated UST operator inspection report and provided a <br /> isr <br /> PR description of the action(s)taken or to be taken to correct any compliance issues discovered. <br /> w" <br /> Name of UST owner/Operator(print) <br /> UST Owner/Operator Signature Date Signed <br /> 7. INSPECTION HISTORY <br /> Has each follow-up action of Section 3 from the previous Designated UST Yes NoNA <br /> Operator Inspection Report been completed appropriately? ❑ ❑ <br /> Attach documentation vegbqng appropriate service to this report.) <br /> 8. RELEASE DETECTION ALARM HISTORY <br /> Attach a copy of the alarm history reportllog to this report. Yes No NA <br /> Is the monitoring system powered on and in proper operating mode? 5 ❑ 4. CERTIFICATION 13Y <br /> Has each alarm since the previous inspection been responded to appropriately? l hereby certify that the <br /> f (Attach documentation verifying appropriate service to this report.) ❑ ❑ of Regulations,title 23, <br /> 1F'vol� herein is accurate. <br /> Have all containment sumps,that have had an alarm since the previous <br /> designated UST operator inspection report,been responded to by a qualified ❑ © Designated UST Operat <br /> Phone <br /> service technician? <br /> ERS=California Envirn <br /> Alf answers marked"No'must be described by the designated UST operator in Section 3. 11 Identification,NA=Not <br /> � / <br /> Storage Tank <br /> Page a of 4 <br /> John Alaniz, REHS Page 5 of 6 <br />