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1800 North California Street PR0231036 <br /> September 27, 2021 Program: UST <br /> PHOTO 10: Amy Winkler is not on DO ID form in CERS. Zip code is incorrect. <br /> Appendix XIII <br /> Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 1.FACILITY INFORMATION <br /> CERS ID 10181397 <br /> Inspection Date 6/3/27 <br /> Facility Name ST JOSEPHS HOSPITAL <br /> ip Code 95213 <br /> Facility Address 1800 N CALIFORNIA ST <br /> City STOCKTON RATOR INFORMATION <br /> 2.DESIGNATED UST OPE <br /> i Name of Designated UST Operator Amy Winkler Phone 209-744-0112 <br /> ICC Certification 9951352-UC <br /> Certification Exp Date 3/2612023 <br /> 3.COMPLIANCE ISSUES <br /> Identify by number al/compliance issues listed <br /> i <br /> 4.CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> I I hereby certify that the visual inspection was pei ompliance with California Code <br /> of Regulations,title 23,division 3,chapter 16, ction 2716 a all information provided <br /> herein is accurate. <br /> Designated UST Operator Signature IDate Inspectio Report Provided to Owner <br /> � 11t1tIkjB1 6/3/21 <br /> CERS=California Environmental Reporting Syste C=International Code Council,ID= <br /> Identification,NA=Not Applicable,UDC=Under-Dispenser Containment,UST=Underground <br /> Storage Tank <br /> Page 1 of 4 <br /> "-NIMBI <br /> Lydia Baker, SR. REHS Page 10 of 22 <br />