Laserfiche WebLink
Appendix XIII <br /> Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 1 . FACILITY INFORMATION <br /> CERS ID 10124584 Inspection Date 5-08 -2021 <br /> Facility Name FLYERS 427 <br /> Facility Address City ZIP Code <br /> 3300 WATERLOO RD STOCKTON 795205 <br /> 2. DESIGNATED UST OPERATOR INFORMATION - <br /> Name of Designated UST Operator Phone <br /> CLENT GAGNIER 530-521 -6818 <br /> ICC Certification Certification Expiration Date <br /> 5243792 10 -6-2022 <br /> 3 . COMPLIANCE ISSUES <br /> Identify by number all compliance issues listed <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 /> CERS = California Environmental Reporting System , ICC = International Code Council , ID = <br /> Identification , NA = Not Applicable, UDC = Under-Dispenser Containment, UST = Underground <br /> Storage Tank <br /> Page 1 of 4 <br />