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e Famill.S allF OicrredSincc IJ1'® <br /> VAiN Dib Fvj�'NLV PETkOLEUM <br /> .5czae7c,1ry 4ee a� llaatz Pce'rcecuo't 71ccda <br /> To; Cal/EPA Unified Program Date; 12-27-2012 <br /> Re; Request for CERS Organization <br /> My business/organization wishes to establish an identity in CERS to support our electronic reporting of <br /> facility data to unified Program regulators. I certify that I am an authorized representative of this <br /> business/organization and have the authority to authorize others to have access and conduct Unified <br /> Program reporting for my business/organization. I have provided a complete list of only those facilities <br /> for which my business/organization is responsible for reporting. <br /> -- <br /> Signature; <br /> Title; General Manager/Owner <br /> Email; dbatwater@vandepol.us <br /> Phone; (209)944-9115 <br /> CERS Organization Name; Van De Pol Enterprises, Inc. <br /> Organization Headquarters; Stockton, Ca <br /> Organization Users; <br /> 1. David Robinson drobinson@gofds.com Lead User <br /> 2. David Atwater dbatwater@vandepol.us Lead User <br /> 3. Ron Souza rsouza@vandepol.us Lead User <br /> Universal Facility#101 4895 S. Airport Way, Stockton, Ca 95206 <br /> ID#12217 <br /> Universal Facility#102 875 Stillwater Rd, Suite 500, West Sacramento, Ca 95605 <br /> ID#FA0015102 <br /> Universal Facility#103 1001 South Berkeley,Turlock, Ca 95380 <br /> ID#57 <br /> Universal Facility#104 373 South Highway 59, Merced, Ca 95341-6939 <br /> ID#000001271 <br /> VanDePol.us • INeedOilxom ® SrandedFuels.eom <br /> Sacramento e Stockton o Turlock 0-,Ilerced • Fresno 0 Tranquillity <br /> 1895 South Airpo►-t Ray, Stockton, CA 05206 (916) 442-0676 Sacramento (209) 722-2752® Merced <br />