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• UNDERGROUND STORAGE TANK <br /> FACILITY EMPLOYEE TRAINING CERTIFICATE (Page 1 of 1) <br /> 1. FACILITY INFORMATION <br /> Business Name (Same as Facility Name or DBA-Doing Business As) CERS ID <br /> UNOCAL 76 110181433 <br /> Business Site Address City ZIP Code <br /> 2701 MARCH LANE STOCKTON 95219 <br /> II. DESIGNATED UNDERGROUND STORAGE TANK OPERATOR INFORMATION <br /> Name of Designated UST Operator Providing the Training (Print as shown on the ICC Certification) <br /> Kris Bell <br /> Mailing Address Phone# <br /> 680 Quinn Ave San Jose CA 95112 (408) 971-2445 <br /> ICC Certification# ICC Certification Expiration Date <br /> 8833000 10/4/25 <br /> III. FACILITY EMPLOYEE INFORMATION <br /> Individuals assuming the duties of the facility employee before October 13, 2018 must be trained within 30 days of performing <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. <br /> Check this box if a list of the individual(s) trained is appended to this form. The appended list, at a minimum, must contain <br /> all of the information in this section. <br /> Date of Assuming <br /> Name of Individual(s) Trained Initial Training Date Responsibility as a <br /> Facility Employee <br /> Maxine Sigala 06/28/23 06/28/23 <br /> IV. CERTIFICATION BY 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, Division 3, Chapter 16, Section 2715(c) and all the information provided herein is accurate. <br /> Training Designated UST Operator Signature Date of Training <br /> 1112/23 <br /> CERS=California Environmental Reporting System,ID=Identification,ICC=International Code Council, UST=Underground Storage Tank <br />