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Appendix XII <br />Underground Storage Tank <br />Facility Employee Training Certificate (Page 1 of 1) <br />Business Name (Same as Facility Name or DBA -Doing Business As) <br />UNFI Grocer's Distribution, Inc. - Stockton (Piccoli) <br />Business Site Address <br />1990 N. Piccoli Road <br />City <br />Stockton <br />CERS ID <br />10181455 <br />ZIP Code <br />95215 <br />�....,�.�.. �..•• �..���.�������� ���C r�Ntc �P�R�TUR I�Fo1��UlA7fC3N <br />Name of Designated UST Operator Providing Training (Print as shown on the IGC Certification) <br />Tyler Nakaue <br />Mailing Address <br />1141 Sibley Street, Folsom, CA 95630 <br />ICC Certification # <br />10112437 <br />Phone # <br />(209)323-9985 <br />ICC Certification Expiration Date <br />10/1512023 <br />r.v �.c :a �r�uH ivnr tsX u 5rUNATED U.5°TC FJPE A !R CC3I�IDUCTIN� TWIS �R�1II��I�I'G <br />The facility employees listed above have completed the required training in accordance with <br />California Code of Regulations, Title 23, Division 3, Chapter 16, Section 2715(c) and all the <br />information provide herein is accurate. <br />Tri Designated UST Operator Signature Dat�of raining912 <br />CERS = California Environmental Reporting System, ID = Identification, ICC = International Code <br />Council, UST = Underground storage tank <br />Date of Assuming <br />Name of Individual(s) Trained <br />Initial Training Date <br />Responsibility as a Facility <br />Employee <br />V <br />e v� <br />air a� <br />a <br />t .� .�•. <br />� l 2 � Z Z <br />g 1 °i z <br />� �Q� � <br />��77— Gi - P <br />r.v �.c :a �r�uH ivnr tsX u 5rUNATED U.5°TC FJPE A !R CC3I�IDUCTIN� TWIS �R�1II��I�I'G <br />The facility employees listed above have completed the required training in accordance with <br />California Code of Regulations, Title 23, Division 3, Chapter 16, Section 2715(c) and all the <br />information provide herein is accurate. <br />Tri Designated UST Operator Signature Dat�of raining912 <br />CERS = California Environmental Reporting System, ID = Identification, ICC = International Code <br />Council, UST = Underground storage tank <br />