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Appendix VI <br />Underground Storage Tank <br />Monitoring System Certification Form <br />TYPE OF ACTION ❑ Installation ❑✓ Repair ❑ 12 Month <br />UE046 <br />1. FACILITY INFORMATION <br />CERS ID <br />10207021 07/15/2025 <br />Certification Date <br />Facility Name <br />PACIFIC BELL TELEPHONE CO. DBA AT&T CALIFORNIA <br />Facility Address <br />907 LINCOLN RD. <br />City <br />STOCKTON <br />ZIP Code <br />95207 <br />2. SERVICE TECHNICIAN INFORMATION <br />Company Performing the Certification <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 Test <br />Darren Sciume <br />Contractor/Tank Tester License Number <br />588098 <br />ICC Number <br />8223550 <br />ICC Expiration Date <br />05-14-2026 <br />3. TRAINING AND CERTIFICATIONS <br />Manufacturer and Test Equipment Training Certifications <br />Expiration Date <br />Veeder-Root B35390 <br />08-02-2025 <br />4. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br />I hereby certify that the monitoring system is operational in accordance with California Code <br />of Regulations, title 23, division 3, chapter 16, section 2638; that required supporting <br />documentation is attached; and all information contained herein is accurate. <br />Service Technician Signature <br />L�p <br />Date <br />07/15/2025 <br />Total # of Pages <br />6 <br />CERS = California Environmental Reporting System, GPH = Gallons Per Hour, ID = Identification, <br />ICC = International Code Council, LLD = Line Leak Detector, NA = Not Applicable, SW = Single - <br />Walled, UDC = Under -Dispenser Containment, UST = Underground Storage Tank, <br />VPH = Vacuum/Pressure/Hydrostatic <br />Page 1 of 6 <br />