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07,'22/2008 10'04 FAX REG <br /> P\-) SEP ® 8 2008 <br /> Owner,Mat,emeits of Designated Underground Storage saw®Q <br /> Ope-rator <br /> SAriJOAkUNTY <br /> n-ce with UST <br /> and Understanding of and Complia Tri H IDIEPARTM'E <br /> P, My Name: ci <br /> -TC-3s(-30 for cis is fFoarn=, <br /> o [I Change cif Design3te,01()perator <br /> FACil'ibl nF F1'W#: C;ITipcalc F.xviratim Dam <br /> DESIGNXFE 1)UST()PFRATOR FOR TRfS FACILITY; <br /> PRIMARY <br /> Servicu Technician <br /> OPCWOr"s Nu'llt' Lyl,IE 1). N11MMO <br /> AFr-QKDA-TFSJ- ]cc fi 5249115-1-I: <br /> 'LC <br /> 2()q 744-0112 Expimtiorl Elate: 7.'4�2t7419 <br /> ALTERNATE I <br /> E)csj gnarcil C)Vej,ntoT'�Nome: I)Avjj),/iL WINKLER <br /> 10T-�Nam,!, <br /> Name: AFORDA-TLST iCC=P <br /> De-s1gtn2�ii4;d 20()744-0112 <br /> ,�112 7 �O <br /> 2LUrFRNATlZ 2 <br /> L)Q,,;ignated,0perat0r'S Name: ZANE A-NIMMO <br /> Business Name-. A VFORDA-IT',$] [cc 5203322-1JC <br /> r)Q, Fvrjiration1)riic: 3/1412014) <br /> .jgnawd Operaksr's Pholiv$9. 1-09744-011'? <br /> AUI*FRNATE .3 <br /> M;Signal W- Opmtor's Name: FELIX G ftAN11KFZ <br /> Busmcs,i Nalne'. AFFORDA-TEST 1CC 9 527'034A!6' <br /> W; 209 734-{11 1? Dmc- 1&121 <br /> y that,CoFffie'facility iodic: wd at tk-top C'f this p tie,th-c individuals li"ted alinve tvil]:;ervc as V"i Sn <br /> awd L's <br /> tLjjy facility irlspt;ctions and anniml facility uwploycc trainiliz,in <br /> opeyulvna. 'Jhe;in(jividuais will con(juctand docurvu-nit Mun <br /> aecordzmcc w4h Califkinlia Cade of Regulations,title 23.Section 271: (c)-(1). <br /> Furihermtire, I andmuzad and am in compliAllee with the requirements (Matutex, regulatiolm-4, and local <br /> ordinancv,$) applicable to underground i4orage tanks. <br /> NAME, OF TANK OWNER (Print); <br /> STGNATURE OF TANK OWNER: <br /> DATE; Me Nj EIV A, P H 0 N E.C. <br /> Stj UMrrTjL-,C <br /> j0r4PLU7TD FORM TOT14F LOCAI A(-'-FNry(NOT NYATF;WATFRRESO U <br /> RCYSCONTROLPA)A" <br /> AFTER SICNING THF.1,()CALAGENCY LIST IS.AVA ILADIX AT- n <br /> t.L <br /> 2)N(-'Tlf•-VTHEIA)CALA('vFNC.VOF,"V(-,,HAINCESTOTHISFNFORMATIONWn-Hl'iti3*DAy',%OFTHE(-,'IIAN(;F- <br /> 9TTO",L:01 :WOdA di7T:20 e002-22-1nr <br />