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16 East Harding Way PR0231136 <br /> February 15, 2022 Program: UST <br /> PHOTO 1: Am Winkler be an conduction DO ' ections on 5/6/21 and was not re orted in CERS. <br /> U <br /> [_ <br /> so <br /> Appendix XIII <br /> Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 1.FACILITY INFORMATION <br /> CERS ID 10181239 <br /> Inspection Date 5/6121 <br /> =,y Name A&A GAS AND FOOD <br /> L11 Address <br /> Address City ZIP Code <br /> EAST HARDING WAY ISTOCKTON 95204 <br /> z. VESIGNATED UST OPERATOR INFORMATION <br /> "-e of Designated UST Operator Phone <br /> Am Winkler 209-744.0112 <br /> ICC Certification <br /> 9951352-UC Certification Expiration Date <br /> 3. COMPLIANCE ISSUES 3/26/2023 <br /> T-1 UNLEADED R-OVERFILL ALARM 5/4/21 <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 d all information provided <br /> herein is accurate. I <br /> Designated UST Operator Signature Date Inspection Report Provided to Ownaner 1 <br /> 4 <br /> 5/6/21 <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 1 of 4 <br />