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Address Chevron, 1229 E. Louise, Manteca CA 95336 Record ID PRO527041 <br /> Date 8/16/2022 Program: UST <br /> PHOTO 5: <br /> S4 (91 product) alarm on 12/28/2021 not addressed in the DO re ort. <br /> u,,uG,yrvuna storage Tank <br /> Designated UST Operator Visual Inspection epor <br /> 1. FA�11D <br /> ITY INFORMATION <br /> CERS 10186837 Inspection Date 12129/21 <br /> Facility Name Manteca Gas and Food-Chevron <br /> Facility Address City I ZIP Code <br /> 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 9/2122 <br /> 3. COMPLIANCE ISSUES <br /> No compliance issues were at this period <br /> i <br /> I <br /> 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> i <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 /> 6h o <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 /> UN-111 www.unidocs.org Rev.10/01120 page 1 of 4 <br /> Gabriela Garcia-Mejia, EHS Page 5 of 6 <br />