COMPLIANCE INFO_2004 - 2007 - Laserfiche WebLink

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1 Owner Statements of Designated Underground Storage Ta (UST) Operator and Understanding of Compliance with UST Requirements Facility Name:ARCO—06080 Facility ID#:06080 Facility Address: 85 E LOUISE AVENUE Reason for Submitting this Form(Check One) LATHROP, CA 95330 X Change df Designated Operator Facility Phone#:(209) 983-9144 ❑ Update Certificate Expiration Date Designated UST Operator(s) for this Facility PRIMARY Designated Operator's Name:James Wolf Relation to UST Facility(Check One) Business Name(If different from above):Belshire Environmental Services,Inc. ❑ Owner ❑ Operator ❑ Employee Designated Operator's Phone#:949-460-5200 ❑ Service Technician X Third-Party International Code Council Certification#: 5296382-UC Expiration Date: 10/12/2008 ALTERNATE 1(Optional) Designated Operator's Name:refer to backup document Relation to UST Facility(Check One) Business Name(If d fferent from above): ❑ Owner l❑ Operator ❑ Employee Designated Operator's Phone#:refer to backup document ❑ Service Technician X Third-Party International Code Council Certification#:refer to backup document Expiration Date:refer to backup document ALTERNATE 2 (Optional) Designated Operator's Name:refer to backup document Relation to U T Facility(Check One) Business Name(If different from above):refer to backup document 11Owner ❑ Operator ❑ Employee Designated Operator's Phone#:refer to backup document 11 Service Technician X Third-Party International Code Council Certification#:refer to backup document Expiration D te:refer to backup document I certify that, for the facility indicated at the top of this page,the individual(s) listed above will serve as Designated UST Operator(s). The individual(s)will conduct and document monthly facility inspections and annual facility employee training, in accordance with California Code of Regulations,title 23, section 2715(c) - (f). Name of tank Owner(print): Chris Moul Signature of Tank Owner: Date: 12/14/07 Owner's Phone# (714) 690-2349 In December 2004,BP West Coast Products,LLC submitted a separate letter to the local agencies documenting compliance with UST regulations. A copy of this letter can be made available upon request.