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Owner Statements of Designated Underground Storage Tank (UST) Operator <br /> and Understanding of Compliance with UST Requirements <br /> Facility Name:ARCO—02076 Facility ID#:02076 <br /> Facility Address: 800 E KETTLEMAN LN Reason for Submitting this Form(Check One) <br /> LODI, CA 95240 X Change of Designated Operator <br /> Facility Phone#: (209) 334-3678 ❑ Update Certificate Expiration Date <br /> Desianatcd UST Operator(s) for this Facility <br /> PRIMARY <br /> Designated Operator's Name:James Wolf Relation to UST Facility(Check One) <br /> Business Name(If different from above):Belshire Environmental Services,Inc. ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:949-460-5200 ❑ Service Technician X Third-Party <br /> International Code Council Certification#: 5296382-UC Expiration Date: 10/12/2008 <br /> ALTERNATE 1(Optional) <br /> Designated Operator's Name:refer to backup document Relation to UST Facility(Check One) <br /> Business Name(If different from above): ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:refer to backup document ❑ Service Technician X Third-Party <br /> International Code Council Certification#:refer to backup document Expiration Date:refer to backup document <br /> ALTERNATE 2 (Optional) <br /> Designated Operator's Name:refer to backup document Relation to UST Facility(Check One) <br /> Business Name(If different from above):refer to backup document ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:refer to backup document ❑ Service Technician X Third-Party <br /> International Code Council Certification#:refer to backup document Expiration Date:refer to backup document <br /> I certify that, for the facility indicated at the top of this page,the individual(s) listed above will <br /> serve as Designated UST Operator(s). The individual(s)will conduct and document monthly <br /> facility inspections and annual facility employee training, in accordance with California Code of <br /> Regulations, title 23, section 2715(c) - (f). <br /> Name of tank Owner(print): Chris Moul <br /> Signature of Tank Owner: <br /> Date: 12/14/07 Owner's Phone# (714) 690-2349 <br /> In December 2004,BP West Coast Products,LLC submitted a separate letter to the local <br /> agencies documenting compliance with UST regulations. A copy of this letter can be made <br /> available upon request. <br />