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4950 Buckley Cove Way PR0231028 <br /> January 13, 2022 Program: UST <br /> OPHHOOT, illIncom atrainin certificate. <br /> ra cI SZl9 <br /> :Il UNDERGROUND STORAGE TANK <br /> ! FACILITY EMPLOYEE TRAINING CERTIFICATE(Page t ort) <br /> I. FA!CILIOTINFR ATION CERS ID <br /> `� Bualaaae Nam(Sam asF lily Name nr DBA-0oing Business As <br /> 7 RIVER POINT MARINA 1018441 <br /> Business Site Address City ZIP Cade <br /> 4950 BUCKLEY COVE WAY STOCKTON 95219 <br /> It. <br /> DESIGNATED UNDERGROUNK OPERATOR INFORMATION HIRE DA <br /> Neme m Designaletl UST Cperelor Providing the Treinirg(PMt es 6ficesonJFelix Ramirez Meiling Addis Phone#416 2nd Street Galt CA 95632 209 744-0112ICC Cenifiwgon# 'on Espireaon Date <br /> 8883072-UC 3/1/2020 <br /> 111. FACILITY EMPLOYEE INFORMATION I <br /> Individuals assuming the duties of the facility employee before October 13,2018 must be trained within 30 days of performing Ind <br /> facility employee duties.Individuals assuming the duties of the facility employee on and after October 13,2018 must be trained <br /> before performing facility employee duties. (7 <br /> / / <br /> Check this box ffa list ofthe individuals)trainedis eAlawdedto this form.Theappendedlist,are minimum,must contain <br /> all of the information in this section. <br /> Date of Assuming <br /> Name of hallvidual(s)Trained Initial Training Date Reapmnibility as a <br /> Facility Employee <br /> 6>r 'S 6 ?f I <br /> �J-b"-1 V-4wo"PI 3 (S(Zl 08 2 <br /> 6o <br /> T t2 s !7 <br /> -17 <br /> 0-2`( <br /> 2-1 <br /> I. - <br /> N. CERTIFICATION 6Y DESIGNATED UST OPERATOR CONDUCTING THIS TRAINING <br /> TMp facility employees flared above have comp d[here <br /> p3,Division 3,Chapter 16,Section 27t 4 o�datreining in accordance with Calif..,.Code Of Regulations, <br /> iltle 5( d all the information providetl herein Is accurate. <br /> 0,Deeignaled UST epe—Signaiwe <br /> Cafeof Trelning r <br /> i� 4/9/2021 <br /> ,canm®�ao.retplaere,en�Ymn.i la�esmm,,,ice=ir�,r�alcaee <br /> meant Dsr=Udagarld sraageTak <br /> / <br /> Lydia Baker, SR. REHS Page 5 of 5 <br />