Laserfiche WebLink
MAR -6-2008 12:15P FROM: TO:468 <br />Ivor uq uo 16:u4a otirruld CM1111rdrie ^' <br />MAR - 6 2008 <br />SAN JOAQUIN COUNTY <br />Owner Statements of Designated Underground Storage T (GIST) ENTAL <br />LTH DEPARTtVIEN <br />and Understanding of and Compliance with UST Requirements <br />Facility <br />Name: T, ewy T � Facility lD: <br />FaciThy Address- 3940 N. Tracy Blvd. Ramon for Submitft this Fon® (check One) <br />• X Chanse of Daignowd Operator <br />Phone 9: (209) 832-5006 .p i M UP&MCeraiHcen Expiration Date <br />DaigLvated V5T ®oerato � I'or this Faciliiv <br />recanxrsaci <br />Designated Operator's Name: Robert Barnhut <br />Relation to UST Fadift ((;hark Orre/ <br />❑ per G opuaw O Empboyce <br />O serviceTeduddan X Tt wd.Party <br />Business Name (ydd&reatfr= above): ReliableFetroleum Services, Gm. <br />Designated Operswes Phone -4: (209) 604-9336 <br />hmmatianal Code Council Cal fication t!: 5252540 -UC <br />Eviration Paw: lanmy S�*' ?4#0 <br />f <br />u i <br />■ . 1 is ■ . r <br />is. � :,'. �, a � w ., <br />FAPIVIA;40A r' 3 <br />Dc:Wgr=d Opautors Nwnc. <br />Business Name (If &ffereqtfrom abow): <br />Designated OpwwAes Phone -t: <br />International OxIe Council Certification #: <br />4 <br />I certify 111tat, for the facility indicated at ffie top of this page, the individual(s) libted above win <br />serve as Desipated UST •► i t r; rual(s) will conduct and document mti r <br />Ny <br />of <br />Regulations, rr <br />Furthermore, X understand and am in compliance with the requirements (stat <br />regulations, and local ordinances) applicable to undergroundsterage tanks. <br />4 <br />• ! i R' ' 1; 4 4 WWA"". <br />RESOURCES CONTROL BOARD) BY JAIil,03-�.'it 1, <br />AT.- www—w9gLbma 103, <br />• t: a 1111 III r 11111 . r, a r <br />RE <br />reins 1: 1x4i; E14:194 <br />November 2004 <br />