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by 0 • <br /> BP West Coast Products LLC <br /> G' O 4 Centerpointe Drive <br /> La Palma,CA 90623 <br /> ENVIR�NM�FR�1 SES <br /> Owner Statements of Designated Un;uqMound Storage Tank (UST) Operator <br /> and Understanding of Compliance with UST Requirements <br /> Facility Name:ARCO-9600 Facility ID#: <br /> Facility Address: 1250 N WILSON WAY Reason for Submitting this Form(Check One) <br /> STOCKTON,CA 95202 X Change of Designated Operator <br /> Facility Phone#:209.465-5359 1 ❑ Update Certificate Expiration Date <br /> Desienated UST Ouerator(s) for this Facility <br /> PRIMARY <br /> Designated Operator's Name:James Cusick Relation to UST Facility(Check One) <br /> Business Name(Ifaliferenifrom above):Delta Environmental Consultants,Inc. ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:916-601-9337 ❑ Service Technician X Third-Party <br /> International Code Council Certification#: Temporary Certificate Expiration Date: 12/18/2006 <br /> ALTERNATE 1(Optional) <br /> Designated Operator's Name:refer to backup document Relation to UST Facility(Check One) <br /> Business Name(Ifdi,Jferent from above):refer to backup document ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:refer to backup document ❑ Service Technician X Third-Party <br /> International Code Council Certification#:refer to backup document Expiration Date:refer to backup document <br /> ALTERNATE 2 (Optional) <br /> Designated Operator's Name:refer to backup document Relation to UST Facility(Check One) <br /> Business Name(Ifdierentfromabove):refertobackup document ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:refer to backup document ❑ Service Technician X Third-Party <br /> International Code Council Certification#:refer to backup document Expiration Date:refer to backup document <br /> I certify that, for the facility indicated at the top of this page, the individual(s) listed above will <br /> serve as Designated UST Operator(s). The individual(s)will conduct and document monthly <br /> facility inspections and annual facility employee training, in accordance with California Code of <br /> Regulations,title 23, section 2715(c) - (f). <br /> Name of tank Owner(print): Chris Moul <br /> Signature of Tank Owner: z <br /> Date: 12/22/2004 Owner's Phone# (714) 690-2349 <br /> In December 2004,BP West Coast Products,LLC submitted a separate letter to the local <br /> agencies documenting compliance with UST regulations. A copy of this letter can be made <br /> available upon request. <br /> November 2004 <br />