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Received on 09/06/2022 via email <br /> Model <br /> Tank and Secondary Containment <br /> Assessment Document <br /> This document was prepared for: <br /> North County Recycling <br /> Company name: Center & Sanitary Landfill <br /> Address: 17720 E. Harney Ln. <br /> City, California ZIP: Lodi CA 95240 <br /> Tank/system identification: USED MOTOR OIL <br /> Include a description of the tank/tank system that is being assessed. Examples: <br /> Permit by Rule system (FTU#1) or Tank No. T-10A <br /> Date of inspection(s)/assessment: <br /> Include all inspection and/or assessment dates. Please include any dates used <br /> to confirm data or to examine changes made to tank or system as a result of <br /> recommended corrections. <br /> This report consists of pages. <br /> I certify under penalty of law that this document and all attachments were prepared under my <br /> direction or supervision in accordance with a system designed to assure that qualified personnel <br /> properly gather and evaluate the information submitted. Based on my inquiry of the person or <br /> persons who mange the system, or those persons directly responsible for gathering the <br /> information, the information submitted is, to be the best of my knowledge and belief, true, <br /> accurate, and complete. I am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment for knowing violations. <br /> Engineer's name <br /> SStipNAL EN�� <br /> License Number � <br /> License Type Q° PN K' LO F<`� <br /> Address of engineer <br /> City, State Zip <br /> o_ 71646 <br /> �k <br /> Inspector name (if supervised by <br /> assessor above) `slgT ClV4L <br /> F OF C At�ti° <br /> Date stamped/signed: 5.25.22 <br /> North County Recycling Center & Sanitary Landfill Used Motor Oil <br />