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190410 -655 <br /> UNDERGROUND STORAGE TANK <br /> FDE7SIGNATED UNDERGROUND STORAGE TANK OPERATOR ' VISUAL INSPECTION REPORT (Pagel of 2) <br /> FACILITY INFORMATION <br /> S ID Date of Designated UST Operator Inspection <br /> 10141507 05/29/ 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 /> II . 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 /> 9296393 12/07/20 <br /> III $ 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 /> 1 , N/A Line Tightness Testing- Secondarily Contained and is a Suction System <br /> 2 , N/A Tank Tightness Testing- Secondarily Contained and is a 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 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 DqU gv9M0Oy Knp KNpe <br /> Kraig Kinder41vW0190529105127 <br /> V. OWNER / OPERATOR DESCRIPTION OF FOLLOW- UP ACTIONS <br /> mmmmmmmm <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 . Confinned, no follow-up action necessary . <br /> 3. <br /> 4. - — - - - — - — - - <br /> _ 5 _ <br /> 6. -- - <br /> 7. <br /> 9 . <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 ) UST Ak nperatr Sigru Date Signed <br /> Masood Choudlnuy 04 - 12-2021 <br /> CERS = Califomia ErMronmental Reporting System, ID = Identification, UST= Underground Storage Tank, ICC = Inlemational Code Coundl <br />