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UNDERGROUND STORAGE TANK FACILITY EMPLOYEE TRAINING CERTIFICATE (Page 1 of 1 ) 1 . FACILITY INFORMATION Business;Name (Same as Facility Name or DBA-Doing Business As) CERS ID West Valley Auto Servcie LLC 10184725 Business Site Address City ZIP Code 2615 W Grant Line Road Tracy 195304 II . DESIGNATED UNDERGROUND STORAGE TANK OPERATOR INFORMATION Name of Designated UST Operator Providing the Training (Print as shown on the /CC Certification.) Rick Branchini Mailing Address Phone # 106 Wessex Way Folsom , CA 95630 925 699 - 1396 ICC Certification # ICC Certification Expiration Date 8164986 6/2/2020 III. FACILITY EMPLOYEE INFORMATION Individuals assuming the duties of the facility employee before October 13, 2018 must be trained within 30 days of performing facility employee duties. Individuals assuming the duties of the facility employee on and after October 13, 2018 must be trained before performing facility employee duties . X Check this box if a list of the Individuals) trained is appended to this form. The appended list, at a minimum, must contain all of the information In this section. Date of Assuming Name of Individual (s) Trained Initial Training Date Responsibility as a Facility Employee Rocky Durani 11 /22/2020 11 /23/2020 e IV. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING THIS TRAINING The facility employees listed above have completed the required training in accordance with California Code of Regulations, Title 23, Division 3, Chapter 16, Section 2715(c) and all the information provided herein is accurate. Training Designated UST Operator Signature Date of Training �� 3zaarcj,� 11 /22/2020 CERS = Calftnia Environmental Reporting System, ID = Identfication, ICC = international Code Council, UST = Underground Storage Tank UN412 www. unidoes.org 111 - Rev. 10/01 /18