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RECEIVED 10/11/2022 (1 of 16) <br /> RECEIVED 10/11/2022 ( of 16) <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 (Shop Tank) <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: 07/15/2022 <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 16 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 /> Jordan Baldwin �S�pNAL EN <br /> License # 71646 <br /> Civil Engineer <br /> 2769 Boeing Way 2 <br /> Stockton, CA 95206 <br /> o. 71646 <br /> Inspector name (if supervised by <br /> assessor above) <br /> ClV1r- <br /> aF c \F <br /> Date stamped/signed: 07.28.22 <br /> North County Recycling Center & Sanitary Landfill Used Motor Oil Shop Tank <br />