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2701 West March Lane PR0231176 <br /> December 16, 2021 Program: UST <br /> PHOTO 4: Training certificate with initial training dates that are incorrect. <br /> _]CE_Rs /C7 / DTRAo �/p458–/tI <br /> UNDERGROUND STORAGE TANK <br /> FACILITY EMPLOYEE TRAINING CERTIFICATE(Page 1 011) <br /> 6uslneasName(Same as Pao Name orO6A- 1. FACILITY INFORMATION <br /> UNOCAL 76 N i—gauvr—Ae) CERS ID <br /> 0181433 <br /> Business site Atltlress city <br /> 2701 MARCH LANE STOCKTON ZIP Coe. <br /> 11. DESIGNATED UNDERGROUND STORAGE TANK OPERATOR INFORM 95218 <br /> Name or Dae,9naled UST Operator Providing the T,einin9(Pfint as shown on Ne TCC Ceraficaaon.) ATION <br /> Rha Martinez <br /> Mailing ACdress Phone# <br /> fi, <br /> 680 Quinn Ave San Jose CA 95112 (408)971 2CCCerdf Bon# inetion Date 445 <br /> 9028811 25 21III. FACILITY EMPLOYEE INFORMATIONindividuals assuming the duties ofthe facility employee before October 13,2018 must betrainetl wa sfacility employeedutles.lndiOduals assuming the duties ofthe facility employee on and after Octob ,2018 of certormino <br /> before performing facilityemployee duties. mustbetrained <br /> 1 tD a//of rhe rnfoCheek this ormradon in thfi,list is secaonual(s)trained is appendM to this form.The appended list,ata minimum,must contain <br /> ling Name of Individuals)Trained Initial Training Date Date of Assuming <br /> Respons,bilAy ass <br /> 1: Facility Employes <br /> Karen Mapp 10/16/2019 10/182018 <br /> -� Tiffany Fide 2/7/2019 1/102008 <br /> 'ailSamantha Baxter 2/7/2019 1/192017 <br /> Jackie Null 5/1/2019 <br /> 1127/1989 <br /> �r KAREN MONTGOMERY 1/92020 9/132019 <br /> NAMENT 1/9/2020 8/72019 <br /> ADDISON RHODES 377/2019 3172019 <br /> MARIZARUELAS 2/3/2020 213/2020 <br /> IV. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING THIS TRAINING <br /> rnia Code of Reg Mations, <br /> The facility employees listed above have completed the required training in accordancewith uratCalife <br /> fltle 23,Division 3,Chapter 16,Section 2715(c)and all the information provided . is a <br /> c <br /> c . <br /> Date o-Training yJ20 <br /> Training Designated UST Operator Signature <br /> CERS-CalibrtYa Environments]Reporting Syslem,ID=Idenitkatlon,ICC=In Innte_melloonal I Code Coumll,UST=Urdaigmund StoraAeTon' <br /> Lydia Baker, SR. REHS Page 4 of 6 <br />