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1800 North California Street PR0231036 <br /> September 27, 2021 Program: UST <br /> PHOTO 15: Am Winkler is not on the DO ID form in CERS. Zi code is incorrect. <br /> Appendix XIII <br /> Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> CERS ID 10181391 <br /> Inspection Date 8/25121 <br /> Facility Name ST JOSEPHS HOSPITAL <br /> Facility Address 1800 N CALIFORNIA ST City STOCKTON ip Code 95213 <br /> 2.DESIGNATED UST OPERATOR INP <br /> Name of Designated UST Operator Amy Winkler Phone 209-744-0112 <br /> ICC Certification 9951352-UC Certification Exp Date 3/26/2023 <br /> 3.COMPLIANCE ISSUES <br /> Identify by number all compliance issues listed <br /> qW <br /> �I <br /> o IN <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 /> IIiB/ —_ 8/25/21 <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 /> Lydia Baker, SR. REHS Page 15 of 22 <br />