Laserfiche WebLink
Appendix IX UE046 <br />Underground Storage Tank <br />Overfill Prevention Equipment Inspection Report Form <br />TYPE OF ACTION ❑ Installation ❑ Repair 0 36 Month <br />1. FACILITY INFORMATION <br />CERS ID Inspection Date <br />10207021 7/15/2025 <br />Facility Name <br />PACIFIC BELL TELEPHONE CO. DBA AT&T CALIFORNIA <br />Facility Address City ZIP Code <br />907 LINCOLN RD. STOCKTON 95207 <br />2. SERVICE TECHNICIAN INFORMATION <br />Company Performing the Inspection <br />TAIT Environmental Services, Inc. <br />Phone <br />(714) 560-8222 <br />Mailing Address <br />11280 Trade Center Dr., Rancho Cordova, CA 95742 <br />Service Technician Performing Inspection <br />Darren Sciume <br />Contractor/Tank Tester License Number <br />588098 <br />ICC Number <br />8223550 <br />Expiration Date <br />05-14-2026 <br />3. TRAINING AND CERTIFICATIONS <br />Manufacturer and Test Equipment Training Certifications <br />Expiration Date <br />Emco Wheaton EVR Phase I Systems - VR-104/105 - Certification # 3341 <br />08-31-2025 <br />4. INSPECTION PROCEDURES INFORMATION <br />Inspection Procedures Used <br />Components Inspected <br />PEI RP 1200 <br />UE0460002 Diesel OPV <br />5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING INSPECTION <br />I hereby certify that the OPE was inspected in accordance with California Code of <br />Regulations, title 23, division 3, chapter 16, section 2637.2; that required supporting <br />documentation is attached; and all information contained herein is accurate. I understand <br />that test procedures shall be made available upon request by the governing authority. <br />Service Technician Signature <br />- 9) <br />Date <br />7/15/2025 <br />Total # of Pages <br />2 <br />CERS = California Environmental Reporting System, ID = Identification, ICC = International Code <br />Council, OPE = Overfill Prevention Equipment <br />Page 1 of 2 <br />