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Tank and Secondary Containment <br /> Assessment Document <br /> This document was prepared for: <br /> Company Name: Super Lube Oil Change & Market <br /> Address: 1170 Lincoln Blvd <br /> City, California ZIP: Tracy, CA 95376 <br /> Tank/system identification: Used Oil #6 <br /> Date of Inspection(s)/Assessment: <br /> 1/29/2019 <br /> This report consists of 18 pages <br /> I certify under penalty of law that this document and all attachments were prepared under my <br /> direction or supervision in accordance with a system designed to assure that qualified personnel <br /> properly gather and evaluate the information submitted. Based on my inquiry of the person or <br /> persons who manage the system, or those persons directly responsible for gathering the <br /> information,the information submitted is, to be the best of my knowledge and belief, true, <br /> accurate, and complete. I am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment for knowing violations. <br /> Engineer's Name: Mike Smith Engineering, Inc, <br /> — <br /> License Number: 44590 <br /> License Type: R.C.E. <br /> Address of Engineer: 4 N. Main St./ P.O. Box 611 <br /> Lodi, Ca 95240 <br /> uJ <br /> CC 9D <br /> b <br /> ``- 0 F <br /> Date Stamped/Signed ' <br /> Super Lube Oil Change Market Tank/Tank System Identification: Used Oil #6 <br />