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19255517888 Main Fax GETTLER RYAN INC 10:48:02 a.m. 12-27-2006 2/2 <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> TANKS <br /> UNDERGROUND STORAGE TANKS - INSTALLATION <br /> CERTIFICATE OF COMPLIANCE <br /> (One page per tank) <br /> Page 2_of-2- <br /> 1. <br /> f2I.FACILITY IDENTIFICATION <br /> BUSINESS NAME(Same as FACILITY NAME m DBA-Doing Business As) 3. <br /> Olympian <br /> ADDRESS(For local use only) <br /> 476. <br /> 983 Moffat Blvd.,Manteca <br /> FACILITY ID# 1 TANK 1D# 477 <br /> Diesel <br /> IL INSTALLATION <br /> (Check all that apply) <br /> 478. <br /> ® The installer has been trained and certified by the tank and piping manufacturers. <br /> ® The installation has been inspected and certified by a registered professional engineer having education and experience 479. <br /> with underground storage tank installations. <br /> 480. <br /> ® The installation has been inspected and approved by the Unified Program Agency. <br /> 481. <br /> ® All work listed on the manufacturer's installation checklist has been completed. <br /> 482. <br /> ® The installer has been certified or licensed by the Contractors' State License Board. <br /> ❑ The underground storage tank, any primary piping, and secondary containment was installed according to applicable 483. <br /> voluntary consensus standards and written manufacturer's installation procedures. <br /> Description of work being certified: <br /> Spill Bucket and Drop Tube Replacement on the Diesel Tank <br /> Ill.TANK OWNER/AGENT SIGNATURE <br /> 1 certify that the information provided herein is true and accurate to a best of my knowledge. <br /> 11 SIGNATURE OF TANK OWNER/AGENT DATE 484, <br /> 12/27/06 <br /> NAME OF TANK OWNER/AGENT(pri t) 485 TITLE OF TANK OWNER/AGENT 486. <br /> Gettler-R an,Inc. Agent for Nella Oil <br /> UPCF(1199)HwfWrt-c-1/2 htip://%ww.unidoes.org Rev.02/16/00 <br />