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Owner Statements of Designated Underground Storage Tank (UST) Operator <br /> and Understanding of Compliance with UST Requirements <br /> Facility Name: BP Site 6313 Facility ID#: 6313 <br /> Facility Address: 1 100 S MAIN STREET Reason for Submitting this Form(Check One) <br /> MANTECA,CA X Change of Designated Operator <br /> Facility Phone#:209-825-6784 ❑ Update Certificate Expiration Date <br /> Designated UST Operator(s) for this Facility <br /> PRIMARY <br /> Designated Operator's Name:Tony Duncan Relation to UST Facility(Check One) <br /> Business Name(If different from above):Delta Environmental Consultants ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:916475-4270 ❑ Service Technician X Third-Party <br /> International Code Council Certification#: 5246340-UC Expiration Date: 11/6/2006 <br /> ALTERNATE 1 (Optional) <br /> Designated Operator's Name:refer to backup document Relation to UST Facility(Check One) <br /> Business Name(If different from above): Delta Environmental Consultants ❑ 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(If different from above):Delta Environmental Consultants ❑ 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: <br /> Date: 6/1/06 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 />