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Mar 20209.845-8953 p•312 11:21p J Reliable PetroleumA — • <br /> San 3oaquin County <br /> Environmental Health Department <br /> 600 E. Malin Street Stockton CA. 95202 <br /> l'clepl/one(209)468-3420 Fax(7,09) 468-3433 <br /> Owner S ate(nentS of Designated Underground Storage Tank (UST) Operator <br /> at Understanding of and Compliance with UST Requirements <br /> CH ARCO AM PM rnsint) !p4: <br /> f+acilitc Yante: <br /> ' lteiL9n1'1 for Suhmilu nye Ihig FOOn lCficrk!)nel <br /> •k':uility AJdrsss: <br /> 55 S.H'vtiV 99, STOC K70N. CA 95215 C (;hangs of De.ignated Opc rotor <br /> Io ilityphone b: 209.948-2438 ~_ f3 update Certificate Ex ira'ionNtlt <br /> Desizit ter UST poeratoll-L for this Facility <br /> PRIMARV <br /> Relation to U�r Facilil}'R1>cck UnaJ <br /> DcsiLtnatsd Opernt is Vnmr: ROBERT BARNHART <br /> IlrsirussNamsOr ipe+'arnJrnm,�hnvv;: <br /> RaLAat5 PUROLEVIa afrM-Ea INC. ❑ Owrw ❑ Operator ❑ L•'trployee <br /> Ihsignnecd Opernt is Phone is 209.604-9336 l9 Servic, chnician ❑ Third-Party <br /> lowna'donal Cbo <br /> oac ncil(krlilict.l on 8: 525240-UC Expiation Dates 0112812014 <br /> ALTERNATE r fiaun! <br /> Oeftnatctl O(Mat T'S NonN: GUADALJPE SANCHEL. ItclaCtm .o Uti'f Facility((''heck One) <br /> auxincss Namr(f;' ilfirenrf:•nnr,rbaw/: <br /> nF..ASU PfitRCi.IVAl S6RVIGES tNC. , i3 Uwncr I Operator O YenPtOym <br /> (Jssignated Opsr I r-Minot+" 209-604-9363 12 Service'Nchnician O Third-Party <br /> IntsrnntionalCods 'uuncil('crtilicarimtd: 5250451-UC Expiration0nte: 01129/2013 <br /> ALTERNATE2 Wena)J <br /> !)caigneted Op tnt " Nvry Relation 1V UST 1--UXty(01Ne One/ <br /> BusincsA Nalnc l)/ I//e+'nrn.;'mn uhmMJ: C Owner ❑ Opunow O Kmpinycx <br /> Oes!gnuied Opvratl 's 11110lN 4: O Servlet Technician s 'Third-:'urn• <br /> Irternalianal Code :ooncil Curtilic:nioo Expirshosi Date: <br /> NOTE: THE L AL RFC UL.4TORY AGENCY MUST BE NOTIFIED OF ANY CHANGES TO THIS <br /> INFOR 1AT10N WITHIN 39 DAYS OF THE CHANGE. <br /> I certify that. f r the facility indicated at the top of this page.the individuals) listed above will <br /> serve as Desig aced UST' o)wrator(c). The individual(s) will conduct and document monthly <br /> facility inspect ons and annual facility employee training. in accordance with California Code of <br /> Regulations. ti e 23: Section 27; 5(c) • i)). <br /> Furthermore, understand and am in compliance with the requirements (statutes, <br /> regulations,a d local ordinances) applicable to underground storage tanks. <br /> NAME OF TAN OWNER(Pknsf Print): <br /> SAGE INVESTMENTS,LLC )JIVTESH GILD SANOEEP SINGH <br /> SIGNATUREO TANKOWNER: _, <br /> DATE: 03120/2 12 OWNER'S PHONE*:209-481-74451408-806-9148 <br /> Novornber 2004 <br />