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FACILITY NAME FACILITY PHONE Mid Ci Ca FOReen ( 916 ) 439 - 6042 FACILITY SITE ADDRESS CITY 13850 Devries Road Lodi REASON FOR SUBMITTING THIS FORM(Check One): Q Change of Designated Operator ❑✓ Update of ICC Certification Expiration Date(s) ALTERNATE 4 DESIGNATED UST OPERATOR FOR THIS FACILITY(Optional) Designated Operator's Name: Todd Hansen Relation to UST Facility(Check One) Bussiness Name (If different from above): SunWest Engineering Constructors,Inc. ❑ Owner ❑ Operator ❑ Employee Designated Operator's Phone#: (909)594-9850 ❑ Service Technician 2 Third Party International Code Council Certification#: 8045710 Expiration Date: 1/24/2015 ALTERNATE 5 DESIGNATED UST OPERATOR FOR THIS FACILITY(Optional) Designated Operator's Name: Paul McLane Relation to UST Facility(Check One) Bussiness Name(If different from above): SunWest Engineering Constructors,Inc. ❑ Owner ❑ Operator ❑ Employee Designated Operator's Phone#: (909)594-9850 ❑ Service Technician El Third Party International Code Council Certification#: 5238651 Expiration Date: 1/24/2015 ALTERNATE 6 DESIGNATED UST OPERATOR FOR THIS FACILITY(Optional) Designated Operator's Name: Leonardo Aguilar Relation to UST Facility(Check One) Bussiness Name(If different from above): SunWest Engineering Constructors,Inc. ❑ Owner ❑ Operator ❑ Employee Designated Operator's Phone#: (909)594-9850 ❑ Service Technician 2 Third Party International Code Council Certification#: 5302718 Expiration Date: 1/23/2015 ALTERNATE 7 DESIGNATED UST OPERATOR FOR THIS FACILITY(Optional) Designated Operator's Name: Ruben Becerra Relation to UST Facility(Check On;Pa Bussiness Name (Ifdifferentfrom above): SunWest Engineering Constructors,Inc. ❑ Owner ❑ Operator ❑ E 4 Designated Operator's Phone#: (909)594-9850 ❑ Service Technician El Thi International Code Council Certification#: 5307833 Expiration Date: 1/23/2015 ALTERNATE 8 DESIGNATED UST OPERATOR FOR THIS FACILITY(Optional) Designated Operator's Name: Michael McCarthy Relation to UST Facility(Check One) Bussiness Name(If different from above): SunWest Engineering Constructors,Inc. ❑ Owner ❑ Operator ❑ Employee Designated Operator's Phone#: (909)594-9850 ❑ Service Technician 2 Third Party International Code Council Certification#: 5248502 Expiration Date: 10/22/2014 ALTERNATE 9 DESIGNATED UST OPERATOR FOR THIS FACILITY(Optional) Designated Operator's Name: Relation to UST Facility(Check One) Bussiness Name(If different from above): ❑ Owner ❑ Operator ❑ Employee Designated Operator's Phone#: ❑ Service Technician ❑ Third Party International Code Council Certification#: Expiration Date: