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Sep 1310 09:51 a AFFORDA TEST 209-744-0116 p.1 ffo rda-Te : t 416 2"a Street Phone: (209) 744-0112 : 1. Galt, Ca 95632 Fax: (209) 744-0116 afforda(ar softcom.net nwns+t- Ct•a+AmwnfQ of `npail®nad-Pd ITndwrmrnnaad .S°tnrnaxp Tanlr 0nPratnr and Understanding of and Compliance with UST Requirements • P %1. Facility Name: Country Club Food & Fuel Facility .g Address: 1856 Country Club Blvd Stockton CA XX Update Des Op Facility Phone #: © Change of Designated Operator ❑ New Designated Operator DESIGNATED UST OPERATOR FOR THIS FACILITY: PRIMARY Designated Operator's Name: ZANE MMMT} Service Technician Business Name: AFFORDA TEST ICC #: 5263322 -UC Designated Operator's Phone: 209-744-0112 Expiration Date: 312112 ALTERNA'T'E I Designated Operator's Name: FELIX RAMIREZ Service Technician Business Name: AFFORDA TEST ICC #: 52733934 -UC Designated Operator's Phone- 209 -?44-0112 Expiration Date: 4nf12 ALTERNATE 2 Designated Operator's Name: DAVID WINKLER Service Technician Business Nranc: AFFORDA TEST ICC #: 5263373 -UC Designated Operator's Phone: 209.744-01 J 2 Expiration Date: 3124,12 ALTERNATE 3 Designated Operator's Name: LYLE NIlYMO Service Technician -go, OwAs off 7M ICC #: 5249115 -UC thiall Lie or Expiration Date: 2124112 top of this page, the individuals listed above will serve as Designated UST i document monthly facility inspections and annual facility employee training, in ions, title 23, section 2715 (c) — (f). ipliance with the requirements (statutes, regulations, and local Itorage tanks. MW OWNERS PRONE: 0SI-MMI'I"1.1-tiScof"AI .t:TTIMFl)RMTOT'HF,LOCALAGCNCY'ONOTS`,YR03iA1'"(Ez 7iiitltlV:l.'t'r1F1.C�C'.4I.AUIFNC'r LIST IS AVAILA81-h? A7' tvww.aatarhrs�rds c::.g^Y.hr�a'c��ct�/��aa ��,s� tt z1. 21 NOTIFY THE 1.0CAl. AGENCY CiF' r\T`Y (:HANGFS TO THIN MROR,41AT)ON WITWN .7(t DAYS nr^:lar C-IANC,1 . 01"r7CF;