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07 / 03 / 2006 05 * 48 12099569632 STOCKTO PAGE 03 / 07 <br /> Aey 9i ` }1 <br /> . . 1 It I toi Irl 'gj'j`^i� li is ;.;1rti rh..:;: • .1 <br /> „r <br /> 1„ <br /> _ . <br /> rIlh , <br /> It_ <br /> Bu,lness Name Ssh ', MIS P c111ty Name or DBA in ' uva ss As) ) f <br /> In <br /> B1,131 eaa Site Addresscity <br /> h <br /> < <br /> 0.0"00 Will <br /> .. r <br /> Name of Dosignatod UST Operator providing the Training (Fant as shown on the 'cc rrertiflCattan.) <br /> [have Winkler <br /> Mailing Addres �^ �-- T . __ �F'hone # � <br /> 416 2r. d Street Galt CA 95632 . _ { fl i �c 11 <br /> nnkntttn� <br /> ii rt Gallon F � � y - — ICG Gerliileatlon Fxplratloh Date <br /> if 2/231202 .... <br /> S$ 3059� UG1051 <br /> yfj�,, . <br /> rOt <br /> : . : ' .. • <br /> It III <br /> 41 <br /> .~",_ <br /> Individuals assuming the duties of the facllity employee before October 13, 20'18 must be trained within 30 days of srformin4g <br /> fnellity employee duties. Individuals assuming the duties of the facility +employee on and after October 13, $078 mus � be trained <br /> before performing facility employee duties. <br /> Chock this box If a list of the Individual{s} trained is appended to this farm, rho appended list, at a rrtfnimum, M at contain <br /> oil of the Inforrmatlon In this Seddon. <br /> Date of sauming — <br /> Name of Individual(s) Trained initial Training Date Rotpona bllity as a <br /> Facility mptoyea <br /> Von <br /> o <br /> _.. �Y� -- <br /> ._ f . _ , r �1c1 ?, a E <br /> Wen t �, <br />