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18806 N Lower Sacramento Rd, Woodbridge Record ID PR0232388 <br /> 4/26/2021 UST Inspection <br /> Photo 1: The DO stated on the 1/29/2021 report that Elite IV responded to an 87 STP sump alarm on 1/27/2021. No work order was attached. <br /> Failed to comply with designated operator inspection requirements. <br /> i • . e <br /> Appendix XIII <br /> t Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 1. FACILITY INFORMATION <br /> cERSIO 10181237 <br /> Inspection Date 01-29-20 <br /> Facility Name WOODBRIDOE AWM <br /> Facility Address ZIP Code <br /> 18806 LOWER SAC DI 95642 <br /> 2. DESIGNATED US��O�PE �QR�INFO�RM�ATIO��N <br /> Name of Designated UST Operator Phon <br /> Felix Ramirez LNsor 9hLHx <br /> 209-7 N20wv 4, zozr, y:42 AM <br /> ICC Certification Certi FULL OLHRi <br /> 8883072-UC 3/112 HAV 4, 2020 9:40 AN <br /> 3. COMPLIANCE ISSUES FUEL ALARM <br /> MAY 4. 2021j 5:31 AM <br /> Identify by number a!1 compliartco issues listed <br /> NO TANKS OR LINE TESTING NEEDED <br /> i <br /> L-5 b7 S Tur-L, Akar yv% Sfrl--) <br /> I 9 06 L�,,.er Sacranen <br /> Woodbr,d9e <br /> Cfl 9545E <br /> JA'N•29. 2-121 8: 5 AM <br /> SYSTEM STATUS REPORT <br /> T 3:DELiVERY NEEDEI) <br /> Y <br /> 4. CERTIFICATION eY 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 2776 and all information provided <br /> herein is accurate. <br /> Desiqnated UST Operator Signature Date Inspection Report Provided to Owner <br /> 1-29-2021 <br /> CFRB-Caiifornia environmental Reporting System,ICC=International Code Council,ID= <br /> Identification, NA=Not Applicable,UDC=Under-Dispenser Containment,UST=Underground <br /> Storage Tank <br /> John Alaniz, REHS Page 1 of 6 <br />