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181024 -511 <br /> UNDERGROUND STORAGE TANK <br /> FDES71GNATrED UNDERGROUND STORAGE TANK OPERATOR VISUAL INSPECTION REPORT (Page 1 of 2) <br /> It FACILITY INFORMATION <br /> ID Date of Designated UST Operator Inspection <br /> 10141507 11 / 19/ 18 <br /> Business Name (Same as Facility Name or DBA -Doing Business As) <br /> Manteca CO <br /> Business Site Address Citv ZIP Code <br /> 430 W . Center Street Manteca 95336 <br /> ll . DESIGNATED UNDERGROUND STORAGE TANK OPERATOR INFORMATION <br /> Name of Designated UST Operator (Print as shown on the ICC Certification .) Phone # <br /> Kraig Kinder ( 888 ) 588- 8737 <br /> ICC Certification # ICC Certification Expiration Date <br /> 8296393 12/06/ 18 <br /> III * COMPLIANCE ISSUES <br /> All answers of "M' or `NA " in sections VIl through XI must be explained in this section and may require follow-up action. <br /> 1 N/A Tank Tightness Testing — Secondarily contained and Suction System <br /> 2 • N/A Line Tightness Testing — Secondarily contained and Suction System <br /> 3 . <br /> 4 . <br /> 5 . <br /> 6 . <br /> 7 . <br /> 8 . <br /> 9 . <br /> 10 . <br /> 11 . _ <br /> 12 . <br /> IV. CERTIFICATION BY DESIGNATEDIST OPERATOR CONDUCTING THIS INSPECTION <br /> I hereby certify that the visual inspection was performed in full compliance with California Code of Regulations , Title 23, <br /> Division 3, Chapter 16 , Section 2716 and all the information provided herein is accurate . <br /> mmmmmmm <br /> Designated UST Operator Signatureoo . -g gobyW igKMe, <br /> Kraig KinderD1O1Sl 11911:2951 <br /> V. OWNER / OPERATOR DESCRIPTION OF FOLLOW-UP ACTIONS <br /> All issues listed in Section 111 above must have a description of the follow-up action taken or to be taken to correct the issue on the number <br /> line that corresponds with the number line of the compliance issue listed above in Section 111. <br /> 1 • Confirmed, no follow-up _action necessary, _ <br /> 2. Confirmed, no follow-up action necessary . <br /> 3. <br /> 4 <br /> 5 <br /> 6 . <br /> 7. <br /> 8 . <br /> 90 <br /> 10 . <br /> 11 . <br /> 12 . <br /> VI . OWNER / OPERATOR ACKNOWLEDGMENT OF COMPLIANCE ISSUES <br /> I have reviewed Section III " COMPLIANCE ISSUES " and provided a description in Section V of the action taken or to be taken <br /> to correct the issues discovered . <br /> Name of UST Owner/Operator ( Print) USw �r/Open for SilkpDate Signed <br /> Masood Choudhiuy �— 04 - 12-2021 <br /> CERS = Caiforrla Environmental Reporting System, ID = Identification, UST = Underground Storag= TanK ICC = International Code Counci <br />