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Appendix X111 <br /> Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 1 . FACILITY INFORMATION <br /> (fE—RS ID <br /> 14184725 Inspection Date <br /> F _i1t i\IWest Valley Aute Service L <br /> LC 4120/2021 <br /> Facility Address i <br /> ( t <br /> 'I Grar�t Line D I � !P Code <br /> Tracy 915344 <br /> DESIGNATED ATED UST OPERATOR INFORMATION <br /> Name Of Designated UST raLcr <br /> iPhone <br /> ICralnFinl Bc1 (925) 699-1396 <br /> ICC Ceriffioation Certification Expiration Date <br /> ~� <br /> Aiqt2n22 <br /> 3, COMPLIANCE ISSUES <br /> i' GVRTUS-3SO AFN this period ok 8:35 AM - -Nothing to report this period <br /> ' Mlon t rand Spill bucket certification 313112421 C <br /> 3136 TP' sump al arms per test inspection <br /> .' L-7 Diesel sensor f1 <br /> ISD 3159 43130 Ilse r r'pla a ent <br /> Need B-989 test results <br /> i <br /> r <br /> . CERTIFICATION By DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> I hereby certify that the visual inspection was performed in COCA Bance with California� od <br /> of Regulations, title 23, division 3, chapter I6, section 2716 and all information <br /> 2provherein Is la u rate. <br /> ided <br /> }e 1,,;gated UST Operator Signature Date Insp%etion Report Provided <br /> Digitally signied b Rick Sranccj ti v�, r# r <br /> Date: 2021.04.20 09:07:12 -07'00' r 4120121121 <br /> California En vir orrr ental Reporting orcin System, ICC = International <br /> Ider�t!r� a�tion, Not Applicable, UD - Under-Dis er�s��- Q o�� �I. ID <br /> Storage Tank � � ta�r� r��, I� � - Underground <br /> UN-Iii <br /> www.unidoos.Qfg Roar. 10101120 Page 1 of <br />