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Owner Statements of Designated Under'gr'ound Storage Tank(UST) Operator- <br /> and Understanding of Compliance with UST Requirements <br /> Facility Name:ARCO—05450 Facility ID#: FA0003606 <br /> Facility Address: 1617 W Fremont Reason for Submitting this Form(Check One) <br /> Stockton,CA 92503 ■ Change of'Designated Operator <br /> Facility Phone#; (209)462-1617 ❑ Update Certificate Expiration Date <br /> PRIMARY <br /> Designated Operator's Name:Reid Yeoman Relation to UST Facility(Check One) <br /> Business Name(1fdierentfrom above) Belshire Environmental Services,Inc.. ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:(949)460-5200 ❑ Service Iechnician ■ Ihird-Party <br /> International Code Council Certification#: 5243838-UC Expiration Date:10/16/2008 <br /> ALIERNAIE 1tional <br /> Designated Operator's Name:refer to backup document Relation to UST Facility(Check One) <br /> Business Name(If different from above) ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:refer to backup document ❑ Service Technician ■ Third-Party <br /> International Code Council Certification#:refer to backup document Expiration Date:refer to backup document <br /> ALTERNATE 2 (Optional) <br /> Designated Operator's Name:refer to backup document Relation to UST Facility(Check One) <br /> Business Name(If die),ent from above)refer to backup document ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:refer to backup document ❑ Service Technician ■ Ihird-Party <br /> International Code Council Certification#:refer to backup document Expiration Date:refer to backup document <br /> Designated UST Oper-ator(s) for this Facility <br /> I certify that,for the facility indicated at the top of this page,the individual(s)listed above will - <br /> serve as Designated USI Opetator(s).. The individual(s)will conduct and document monthly <br /> facility inspections and annual facility employee training, in accordance with California Code of <br /> Regulations,title 23, section 2715(c)- (f).. <br /> Name of tank Owner-(print): Chris Moul <br /> Signature of lank Owner: <br /> Date: 05/01/2007 Owne1's Phone# (714) 690-2349 <br /> In December 2004,BP West Coast Products,LLC submitted a separate letter to the local <br /> agencies documenting compliance with UST regulations. A copy of'this letter can be made <br /> available upon request. - <br />