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Address Chevron, 1229 E. Louise, Manteca CA 95336 Record ID PR0527041 <br /> Date 8/16/2022 Program: UST <br /> PHOTO 2: <br /> Missing designated operator signature and date. <br /> 5:06 p. <br /> TYPE: BALHNoe <br /> YBD �ERaroN or. <br /> _ilk <br /> mer �iee■ <br /> Designates LAsz wHRN,»_- spection Report <br /> 1. FACILITY INFORMATION LPST lO PHLLUR£ <br /> CERS ID 10186837 LF ST r isc EVENTS -iction Date 9/7/21 <br /> Facility Name Manteca Gas and Food-Chevron <br /> Facility Address City I ZIP Code <br /> 0 1229 E.Luise Ave 1229 E.Luise Ave 95336 <br /> 2. DESIGNATED UST OPERATOR INFORMATION <br /> Name of Designated UST Operator Phone <br /> Alex Jabbari 925-389-1262 <br /> ICC Certification Certification Expiration Date <br /> 5243897-UC 912122 <br /> J 3. COMPLIANCE ISSUES <br /> 1 No compliance Issues and follow ups <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 /> I <br /> CERS=California Environmental Reporting System,ICC=International Code Council, ID= <br /> I Identification, NA=Not Applicable,UDC=Under-Dispenser Containment,UST=Underground <br /> Storage Tank <br /> UN-111 www.unido s.org Rev.10101120 Page 1 of 4 <br /> Gabriela Garcia-Mejia, EHS Page 2 of 6 <br />