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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 Valle Auto Servcie LLC 10184725 Business Site Address City I ZIP Code 2615 W Grant Line Road Tracy 195304 Il. DESIGNATED UNDERGROUND STORAGE TANK OPERATOR INFORMATION Name of Designated UST Operator Providing the Training (Print as shown on the ICC Certification) Rick Branchini Mailing Address Phone # 106 Wessex Way Folsom , CA 95630 925 699- 1396 ICC Certification # ICC Certification Expiration Date $ 164986 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 individual(s) 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 Melanie Enebarez 7/29/2020 8/ 1 /2020 Ramiro MW 7/29/2020 8/1 /2020 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 2716(c) and all the information provided herein is accurate. Training Designated UST Operator Signature Date of Training C3� u 7/29/2020 CERS = California Environmental Reporting System, ID = Identification, ICC = International Code Council, UST = Underground Storage Tank UN412 www.unidocs. org 111 - Rev. 10/01 /18