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Dec 22 06 04: 10p Rfforda Test (209) 744-0116 p. 1 <br /> Dec 22 06 05-13p KINGDONORT AN& 334 2961 p.1 <br /> Oce Ili UB <br /> 01 t Sop Woroa t est ( ! IdtT-ux tb P• t <br /> Owner Staternents of Dcsignatcd Underground Stor-aV Tank(CST)Operator <br /> and Undmianding of and Comp)iancc with UST RequireMents <br /> t:ecility Niam�4: ! -�tatt4►.a. <br /> smsiticy neJarex c (4100 E• FyG✓ O r)V at". R for Subrut ing Alii,Fora►(Ch -k 0�4 <br /> -& 9 Sa"i sz- Clf age ofINWivstedopcww <br /> t4Ciriay Phoac fl: o .�2L3 Updale CeRttielvt P-LFit pion Due <br /> D _ Sc�a nX%0 UST QoersRa for this Fadi{;ty <br /> r <br /> rRrMRRY <br /> taxi d Oye*uoe's reo�,c: `K' 11 e r>~+rn d� -- t[aatwr w USM raci lity(Clwrk Ong) <br /> M'Vacdo,._ <)Wwr o oc+crwor M Emp:aym <br /> 1-�ipoareJO�e^a'■1�7arn�cN: ��Qq� ►'� �CJE- 2, ServiceTeesmiai®n Ei 'lAlre,1"sr�9 <br /> Iorenemcimaa Code COURCil cemrsmZien N. `a a ti ei l) .»4 N) , Ctacp:raLon Dae_ Ix.Loo J(& , <br /> ALTRRNATtr�.dn+.v/) <br /> txsi (od(5txrnaax•r ri�..c: 7—AK e. A. Fa4ricm I*UST r:...tlity(Clrrrt One) <br /> Busipa m Pdrsee(Jffdrlfe rarfiom rb0 )_ + -. :a ��e�^�LL t�:e (7swe'cr (7 ch-volor Q�Employ" <br /> Dcvtw+rared npeeutau's iftm N: 2c+c y-�j( ( R :sNitC Tc bm,..o O Thiel-ftly <br /> lnecrnsti(r W Code Cot WII CCrtiftCAdM Z +SJ�(rd b:�;�,^{ k:Kpi�tioe tBRtC� a <br /> AJl,.WKNAM Z (OpOvn^0--- y—__ <br /> LionpWa n'ItName, -- p,`3\ L rs�o, k'[f�`Ttm:ilicy(l'le�Alhw) <br /> Ruriam2 _ (jfdj#jwvwrfmmoMsw)' D owner 0 Dpemtoa O ycc <br /> 0a.ivvwW Oper ar'x rham A:_ rL®d� _``,uu_ ^• �( sem a T cysse 4 �7 ad 1'�rty <br /> _Ineer..or:petnt C08C Caxawit Certafient:Aa N�r' G.a� -r 1FaWirneson[ � .Zoe <br /> Nom:nM LOCAL7tT.GULATORY nCENCY&UST AS N(MF,r:.n o)r ANY CRANNCES TO Testi <br /> tN[rORMArION w[THM 30 UAV';OF". J&CHANC& <br /> t,CCtti`y that,for dzt fsC'tlity indiCatC41 at the top of this page„the individuals)listed above will <br /> xerye as Designaw(i UST Open or(s). IN;individual(s)will conduct and d0CW WAt monthly <br /> facility,inspec tiows and=nna.l acilily employee training,in accord=ce with California Codc of <br /> Kcgulallonc,title 23,secticM 2715(c) . (n. <br /> P[urtttc more,1 uadm+ts►teed sed carr ler cor <br /> polmoLce with the requirements(e-- <br /> NAM <br /> rcKab am.and local ordinances)ap cad ton er:rouad srto"20 tank <br /> 0118 T4NK u®Vtvk It(Mmsc t'r' 1): �� ���...��. �.......�._..._.. <br /> owNurs, rttONt•: 09 <br /> QCT-22-,20e? TIS 03:4=dRr•1 M: PAGE:I <br />