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Feb. 2. 2011 0: 16AM 9^1ee Pump Cc. kc. 0358 P. 3 <br /> Stanislaus County <br /> DESIGNATED OPERATOR STATEMENT <br /> I am the "Designated UST Operator" for the following facilities: <br /> Facility Name UST Owner Name Address City <br /> av <br /> As the "Designated UST Operator", I understand the requirements as noted in Section <br /> 2715(a) of Title 23 of the California Code of Regulations (CCR) and the facilities listed <br /> above are in complaince with all applicable UST requirements. <br /> Printed Name and Title �r-yg" 111deAell- c <br /> Signature '�el <br /> ICC "California UST Operator' certificate Number 5293A06 <br /> California UST Operator expiration date 11& 12-01? <br />