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181221 -633 <br /> UNDERGROUND STORAGE TANK <br /> FDTESIGNATED UNDERGROUND STORAGE TANK OPERATOR VISUAL INSPECTION REPORT (Paget of 2) <br /> I : FACILITY INFORMATION <br /> RS ID Date of Designated UST Operator Inspection <br /> 10141507 01 /08/ 19 <br /> Business Name (Same as Facility Name orDBA-Doing Business As) <br /> Manteca CO <br /> Business Site Address Citv ZIP Code <br /> 430 W . Center Street Manteca 95336 <br /> IL DESIGNATED UNDERGROUND STORAGE TANK OPERATOR INFORMATION <br /> Name of Designated UST Operator (Print as shown on the /CC Certification .) Phone # <br /> Kraig Kinder 1 ( 888 ) 588- 8737 <br /> ICC Certification # 712/07/20 <br /> C Certification Expiration Date <br /> 8296393 <br /> Ill. COMPLIANCE ISSUES <br /> All answers of "N" or "NA " in sections Vll through XI must be explained in this section and may require follow-up action . <br /> ' g— _ ng - Secondarily contained and Suction System <br /> 1_ N/A Tank Tr fitness T .__esti _ _ -_- <br /> 2 . N/A Line Tightness Testing - Secondarily contained and Suction System <br /> 34 <br /> 4 . ---- -- -- - - - - - - - -- - -- <br /> 5 . - -- --- <br /> 70 <br /> 8 . <br /> 9 . _ <br /> 10 . <br /> 11 . _ <br /> 12* <br /> IV. CERTIFICATION BY DESIGNATED UST 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 /> Designated UST Operator Signature ogaa'aYt.9^ee , w9w^"� <br /> Kraig Kinder °sa2mam.081saeae <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 lll. <br /> 1 . Confirmed, no follow-up action necessary . <br /> 2 . Confirmed , no follow- up action necessary . <br /> 3 . <br /> 4 . <br /> 5 . <br /> 64 <br /> 7 . <br /> 8. _ <br /> 9. <br /> 10 . --- --- - -- <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 ) UST n1i Operator S' uDate Signed <br /> Masood Choudhary , � A CS O4 - 12 -2021 <br /> CERS = California Environmental Reporting System, ID = Identification, UST = Underground Storage Tank, ICC = International Code Council <br />