Laserfiche WebLink
UNDERGROUND STORAGE TANK SYSTEM <br /> OWNER STATEMENTS OF DESIGNATED UST OPERATOR AND <br /> UNDERSTANDING OF AND COMPLIANCE WITH UST REQUUMMENT$ <br /> C«e.Aw Jl«i.I..n.Arrlw Iww•a....e rJr..mrrwwAb.r..rr..•l�.rvsl_lasierJirlinn <br /> Audwruy cited- rifle 23. Div. 3. Cit. 16 Cal#brrda Code of Regal j0m(CCRt <br /> I FICUJff NA) E------- FACIL _. <br /> SITS ADDRM <br /> leowr ® � ®de,1 i c1 �M_ 1�ROr _� <br /> REASON FOR SUBMITTINO TNIS FORM(Check Ow)' Ub=p of I)v;* nA d Operator Update of l('C Ctan6mtiatl tjwwml . <br /> PRIMARY DESIGNATED US ff f IVO FOR THIS FACLLITY <br /> DmIC NATM OPERATOR NAME: d[/ d.a-i-l1 /JA/I7 4 1 I RELATION TO UST F 1^.'1 _�w <br /> HUSINE4S NAME(Y'dtnatfiw aboty: ❑ Owner ❑ Operator pr <br /> r _ 3 1-1 Cetyioe T_.•T `$' 'Iartl.Prty <br /> ueWONATMUFAIKAIMPHONE. 14/1j )� X1/!1 aaL t - )" <br /> WERNAMONAL CODEmIIwc¢.cAt17FICATION NO.: '3 EXPIRATION -_-- <br /> ALTERNATE 1 DISIGNAUD UST OPMATORFORTSI8 FACLYfY <br /> DESIGNATEDOPERATORNAME: I RELATTONTOUSTFACU1TYttD,Ft :Pm) <br /> WARMS NAW(U mf> abo.e): ❑ ow= ❑ (aEwom$ © h v <br /> r1 twice Ttathniciwn T _ <br /> I iMSJNfI'IAled)VCAY{At4lt rttamn: 1 eXL .•.• <br /> 11nWMTIONAL CODE COUNCLI.CER\ TDIICATION NO.: EXPIRATION DATE: .. .. <br /> AL79RMTE 1 DESIGNATED UST OP&RATOR FOR TMS FACILITY 0 <br /> DESIGNATED OPERATOR NAME: RELATION TO UST FACII.RY{1.(IE.11^^7l�laiik�FrrJ <br /> /_l_ ' n1151N69S NAME(1jd�i+iillinai caroti: I V Vwncr I._.t (ipmnot kwipj* <br /> n Sacviw TGCLgiciOa Tili{d$lRIY <br /> INTERNAnot"t,CODE COUNCIL CERTIFICATION NO.: EXPIRATION DATE: <br /> _— wttr.w+ weM.IN^ yam U/aT----------- - F!(41 try.•• <br /> - <br /> DESNRiAT'PDO"WATORNAME: RETATTONTOUSTFAC►LEI' 670OW0040 -. <br /> n�eacoonna.niyaowwtrj.waw..i. �-1 ❑ I Y» © �= �w i <br /> � "DQt�!'IATL nu�na�atR wrwc. ! ♦ Stsviw Tedmipm 7hlldrlh4ty <br /> Ih'TFJINATUONAL CODE COUNC2 CERTQ'F_'ATION NO.: - .. ' EMPIRA11014 DATE: <br /> 1 car"fit, for dw RtdWy indicated at tie top Of 11" page, the 1n NW M1(a) Usual 11howa wall 00"t M bib <br /> flneramwlal Tie tadlvidusks)will conduct and doctument monthly 6eltltY Imecdons and 110111181 f8cmw MOW"- tMlli ft <br /> _ . F.e+t......... t4—e6 a rl.w..44. <br /> an...�ie.w�av wwa.��. .nr...:«�v..a«araww.rry ..w..+...-...w.. .. .,.y.r .«.....y.. l.l. __..,._-•__._ <br /> In eampnmm wts the regnitements(xn ntes,regniaffone.and iotas o dhmnem)appucauie to aedorwwa116 area w tfni(e,. <br /> 7'.111/44— <br /> m <br /> IANIC()wNkx,Iyl'LC: /1/v/YCiK� avnclraa ririnc.: <br /> nATF• 7//'i-/ J//'i <br /> iNiTYiilTiflNA <br /> a.+wr�rrrw <br /> n��.a.__� r . �. _r...r..�....i,rem.ti�...•..r.♦ a ....i.,.e.A...Nh fl.r inraw.eN..n.i(`n.ir[4em.31 A/If'1.11'If'.>liHM{iiitn <br /> _e__._.a_u__ a_ ...�.a...�I..�4l..wr.r►►wrt Crwni.the.Y`Jiernta 1 IAT Ava}w..(L.w.r6w+ =.._ <br /> 3. 3Villltit title caAlteleted fqm 110 1h0 local BP�IICY roar feRnitlts thin maFdy'a uSTs. Uuiitia �Oa`ew w�!J.-_SRR3la+ <br /> CSMtle[ IRTIaltlantnl we ume 00-mm W. wiww.aapq.Mtn wiwiaiawi. awr.iww n,ia.aynitlpa+-the-mwa <br /> �. e�an.n R41 t..1i/"Apmw wain Y. 7 is n..,m:y.:aY3 w i.;j r.s::�:.�...«....................»....... �....... .,.:+::.e�y . <br />