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Feb 09 10 06:24p <br />I <br />Reliable PetroleumA <br />Owner Statelme >;ts of Designated UndergrOUnd Storage Tank (UST) Operator <br />and Understanding of and Compliance with US's Requirements <br />F.Zci(aty Larne: tj lA I (a�L O/U � FAcii,r+ 10 �; <br />Faeitih Addre;1: oY tal• Qmrlft2y �. Poison for Submitting thea ]corm (Cl" pnf) <br />$+*W+er. C A 4'S L640 p C har.Tte: orDesigmued opmntar <br />Facility ...,. d'r'�O .°° y — °l2 <br />Update Cenilicnat: ExpiraMon Data <br />£iia@T.atpY[�11rh3d�• <br />RMIARX <br />Daignar d OperntorIENar7m! iiovel: trluftttto 7 Focii. <br />CLar <br />raoinieu <br />° Qtvngr d ar i <br />f}esignated Operatws phoane b: �Ioa Q OPeM ❑ Eamp, oven <br />rl' Sanice Technid m 3 rhird-f+tiL+7y <br />tmrntvtiOnal Cede Cotttta id C47affiCntiun : <br />-- _ -- S .S t'/ G Expitili00 Data: <br />(h'SE1111ntntted 0perat0r'5 Name, <br />Basham Name (Ife Are'emr F: <br />LJC"& -'RQ Qpenttor's Pho?le 0; <br />(ntLrnasirntiti Coda Council Cart, tication s: <br />ALTeRNA TIE t Mpr1D4a* <br />2,3ignited t,Tjtewar's Nome: <br />Hucinns idame (l1'd err. JrGurrevbme) <br />Deligntard ()perntI ptoRe #: <br />rptematimaE Code C4tRtC.1 Ccrtifwatiotn a: <br />Relation to JJST Fscliit;• ;Clrcck a+rt') <br />® Owner J7 Ot3eraaor ®Fanpl<*yee <br />M 3Lrvke Techaid:im o T,at:d-Nny <br />FV—i Roan am. <br />Rtlatim to UST Facility (CWck one) <br />D Owner ® OperI Q Empkmee <br />'❑ Servke T=hnician G ThirI <br />Ekpimaj? tom; <br />cortifp that, for dx .facility indicated at he top of this Pa the' the' individuaI(s) listed above will <br />serve as Designated UST 0Perator(s). The indtviduad(S3 wild C4rxduct and document monthly <br />facility ,Ons, t tie 2 and axutual faci <br />