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FROM :SAC INVESTMENT 9 FAX NO. :9164e97113 <br />82/22/2007 13:13 2094663433 EHD <br />f9eb. 22 2006 01:37AM P2 <br />San Joaj�in County <br />Environmental W{64th Department <br />304 E. Weber Ave., Thir�-'-1 Floor Stockton CA 95202 <br />Telephone (209) 4684'��020 Fax (209) 468-3433 <br />T <br />and Unclerstanding of and C^'iii ce with UST Requirements <br />PAGE 02 <br />IV T11"Wr 4" <br />DbSianmd Operator's Name: I Relation to UST Facility (Check One) <br />Business Nam (,Vdfferrmjrom above) - 0 Owner 0 01mrPtov ❑ Employee <br />Designated Opontarlo Yhone Q Service Teclut.1ollan 9 Third -Party <br />Jnftrnadonsl Code Council Certification #_ Expiration DRW! <br />Ar PrV6V A TV I lAft4­11 <br />Detipmed Operator's Name- I <br />Facility M 9; <br />Facility Addrow <br />Rasoj) for Suftitting this Form (Check Om) <br />A41<�' 1-4 1 <br />13 ChaW of Desipated Operator <br />4_,-6 date C,,tiflo.0 Bx trati,, Dat, <br />ralciliv phowZ7 — — <br />�- ZT9 -� 7L <br />IV T11"Wr 4" <br />DbSianmd Operator's Name: I Relation to UST Facility (Check One) <br />Business Nam (,Vdfferrmjrom above) - 0 Owner 0 01mrPtov ❑ Employee <br />Designated Opontarlo Yhone Q Service Teclut.1ollan 9 Third -Party <br />Jnftrnadonsl Code Council Certification #_ Expiration DRW! <br />Ar PrV6V A TV I lAft4­11 <br />Detipmed Operator's Name- I <br />Relation to UST Facility (Cheek One) <br />0 Owner 13 Operator M Employee <br />in Service Tochoicinn 0 Third -Patty <br />Susirllon Name Qfdifferewftom above); <br />Desipsod Operator's Phone #-, <br />1A1ZM4ti*nft1 C" COU11011 CcrtifiCWO" 4! <br />Expiration Date: <br />AlrXE—ATF.2 fl)"finmsh il; <br />Nsionated Operator's Nam: <br />Relation to UST Facility (Check Oise) <br />0 Owner El Operator 0 Employee <br />0 Service TechnJrinn M 7bird-Party <br />Business Name (Ifdfarwntfrom above): I <br />Dcoignow Operator's PRO= <br />International Codc Counefl Certiftetka 91, <br />Expiration D2&: <br />I V2.� CRANGE. <br />i: <br />I certify U4 for the facility indicated at the :of this page, the individual(s) listed above will <br />Serve as Designated UST Operstoj(s). The ind Wdual(s) vAll conduct and document monthly <br />facility inspections and annual facility employe', training, in accordance with California Code of <br />Regulations, title 23, section 2715(c) - (f). <br />Furthermore, I understand and am In <br />regulations. and local ordinances) app <br />SIGNATURE OF TANK OWNER: <br />as with the requirements (statutes, <br />underground storage tanks, <br />Naverl 2004 <br />