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. , C;wtw Statement of DesiAated Undergroun .age Tank (UST) Operator and Understanding of and Con., .ice with UST Requirements — continued ALTERNATE I (Oodonah Designated Operator's Name: Blake Hemess Relation to UST Facility (Check One) ❑ Owner ❑ Operator ❑ Employee ❑ Service Technician ❑D Third -Party Business Name (Ifd fferent from above): Gilbarco/Veeder-Root Designated Operator's Phone #: 951/288-1519 International Code Council Certification #: 5249180 -UC Expiration Date: 12/19/2006 ALTERNATE 2 (Optional) Designated Operator's Name: Cindy Padden Larson Relation to UST Facility (Check One) ❑ Owner ❑ Operator ❑ Employee ❑ Service Technician D Third -Party Business Name (If differentfrom above): Gilbarco/Veeder--Root Designated Operator's Phone M 760/947-1260 International Code Council Certification M 5243667 -UC Expiration Date: 10/31/2006 ALTERNATE 3 (Optional) Designated Operator's Name: Darrell Riley Relation to UST Facility (Check One) ❑ Owner ❑ Operator ❑ Employee ❑ Service Technician 0 Third -Party Business Name (If differentfrom above): Gilbarco/Veeder--Root Designated Operator's Phone M 619/206-8379 International Code Council Certification #: 5248975 -UC Expiration Date: 12/13/2006 ALTERNATE 4 (Optional) Designated Operator's Name: Darren Austin Relation to UST Facility (Check One) ❑ Owner ❑ Operator ❑ Employee ❑ Service Technician El Third -Party Business Name (If differentfrom above): Gilbarco/Veeder--Root Designated Operator's Phone #: 858/699-2751 International Code Council Certification M 5250436 -UC Expiration Date: 12/18/2006 ALTERNATE 5 (Optional) Designated Operator's Name: Eric Banghart Relation to UST Facility (Check One) ❑ Owner ❑ Operator ❑ Employee ❑ Service Technician xO Third -Party Business Name (If d fferent from above): Gilbarco/Veeder-Root Designated Operator's Phone M 310/467-2529 International Code Council Certification M 5250118 -UC Expiration Date: 12/9/2006 ALTERNATE 6 (Optional) Designated Operator's Name: Rayna Guttman Relation to UST Facility (Check One) ❑ Owner ❑ Operator ❑ Employee ❑ Service Technician ❑x Third -Party Business Name (Ifd fferent from above): Gilbarco/Veeder--Root Designated Operator's Phone M 951/850-2318 International Code Council Certification #: 5245973 -UC Expiration Date: 11/16/2006 ALTERNATE 7 (Optional) Designated Operator's Name: Jim Palmer Relation to UST Facility (Check One) ❑ Owner ❑ Operator ❑ Employee ❑ Service Technician I] Third -Party Business Name (If differentfrom above): Gilbarco/Veeder-Root Designated Operator's Phone M 831/840-5235 International Code Council Certification #: 5254109 -UC Expiration Date: 02/21/2007 ALTERNATE 8 (Optional) Designated Operator's Name: Daniel Perez Relation to UST Facility (Check One) ❑ Owner ❑ Operator ❑ Employee ❑ Service Technician ❑D Third -Party Business Name (If differentfrom above): Gilbarco/Veeder-Root Designated Operator's Phone M 916/718-0139 International Code Council Certification #: 5246161 -UC Expiration Date: 11/30/2006 ALTERNATE 9 (Optional) Designated Operator's Name: Relation to UST Facility (Check One) ❑ Owner ❑ Operator ❑ Employee ❑ Service Technician ❑x Third -Party Business Name (If differentfrom above): Gilbarco/Veeder--Root Designated Operator's Phone #: International Code Council Certification #: Expiration Date: