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WESTERN FOOD-FUEL <br /> ;303'2 WATERLOO RD <br /> STOCKTON. CA 95205 <br /> Un1 209-2192-e175 <br /> „�,� :ion Report <br /> Designated UST OCT 20, 2023 4:34 PM <br /> 1. FACILITY INFORMATION s',STEM STATUS REPORT m Date 10/20/23 <br /> CERS ID 10180877 ALL FUIICTIO14S NORMAL <br /> Facility Name Western Food & Fue ZIP Code <br /> Faility Address 195205 <br /> c <br /> 3032 Waterloo Rd <br /> 2. DESIGNATED UST OPERATOR I ALARM HISTORY REPORT <br /> Name of Designated UST Operator ----- SEN-:OR ALARM ----- 89-1262 <br /> Alex Jabbari L 1 :87 STP <br /> STP ur�P cation Expiration Date <br /> ICC Certification SENSOR OUT il1LARM <br /> 5243897-UC DEC b. 20'22 9:54 Arv1 4 <br /> FUEL ALARM <br /> 3. COMPLIANCE ISSUES DEC. 6.. ,702,` 9:34 AM <br /> No compliance Issues SENSOR OUT ALARM <br /> nso is, �o�s iG.�i r1M <br /> SB 989 test is over due <br /> t. <br /> I . <br /> 4. CERTIFICATION 13y DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> 1 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 /> 10/20/23 <br /> CERS = California Environmental Reporting System, ICC = International Code Council I <br />�— Identification, NA Not Applicable _ <br /> Storage Tank , UDC = Under-Dispenser Containment, UST = D <br /> Underground <br /> UN-111 <br /> www.unidocs.org <br /> Rev. 10/01/20 page 1 of 4 <br /> i facility <br />