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2701 West March Lane PR0231176 <br /> December 16, 2021 Program: UST <br /> PHOTO 2:Trainin certificate with initial training dates that are incorrect. <br /> n S <br /> Phone <br /> / CERS �Q / CDTF-- <br /> UNDERGROUND STORAGE TANK <br /> FACILITY EMPLOYEE TRAINING CERTIFICATE,,.,,,°11) <br /> in Name(Same es Pad9ryNama o.oeq- I. FACILITY INFORMATION <br /> UNOCAL]6 D°lnB ausness A;1 <br /> 9uainess stile A.— CERS Ip <br /> 2]01 MARCH LANE City 10181433 <br /> If. DESIGNATED UNDERGROUNTOCKTO <br /> D STORAGE TANKOPERATOR 9 <br /> Name°roes;Bnalea usTo Br —h— <br /> zm cone <br /> Rita Martinez Peref°r Providing the Taimn Pent es shoam on M. Cembcatlon.) INFpRMATIO 5219 <br /> Mailing AOdresa N <br /> 680 Oulnn Ave San Jose CA 95112 <br /> ICC C"n nen# Rhonep <br /> 9028811 ICC Certifldnon 1, (4 Date �)97. <br /> 4 2445 <br /> 116 FACILITY EMPLOYEE INFORMATION 12/1522 <br /> Intlivrtluals assuming the duties oft facll' <br /> JI facility emplo jidies.Individuals assu,In%theduties of the fOacilj�am32078 must <br /> ( before performing facility employee tY employee be train <br /> p yee duties. Yee on and after Octoyeh1733207ays of Pr.'rtormin <br /> n Bmuq betralned <br /> ermitl Chechmis b-ira/isrofrhaindLiduar(s)painWis <br /> a//of rhe intonation in this secfron. aPPendsd to this rcrm.The a <br /> ipen Vio PPendedgs0 ara <br /> minimum,musto-rug, <br /> eturn to <br /> Name of Individuals)Trained <br /> Initial Training Date Date oigsraming <br /> Training Respapsibllay ara <br /> FacIIBy Employee <br /> g Cert iiflany File <br /> I iI r iU Karen Montgomery 03!31/21 <br /> i , /' 01/10Po8 <br /> P Jackie Null 03/02/21 <br /> Contain! 09/13/tg <br /> _- -r Natalie Vincent 05/25/20 <br /> _'.'i r� 1127189 <br /> 'rs Mariza Ruelas 03/02/21 <br /> OBPo7/19 <br /> li <br /> 02/03/20 02lp3/2p <br /> 0 Report <br /> IV. CERTIFICATION 13Y DESIGNATED UST OPERATOR CONDUCTING THIS TRAINING <br /> The facility employees listed above have completed the required training in accordance with California code of Regulations, <br /> Title 23,DIVlalon 3,Chapter 16,Section 2715(c)and all the information provided herein is accurate. <br /> Training Designated UST Operator Signature <br /> (�)' l' Date of Trainin93131/21 <br /> CERS•Cekbrrye EAV110 ental RepoNrg System,ID=Ideniikatbn,JCC=Inleniatioml Code Courcd,UST=Urdelpmund SkMe Tank <br /> Lydia Baker, SR. REHS Page 2 of 6 <br />