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09/02/2009 19:47 2094785509 PACIFIC CAR WASH PAGE 02/03 <br />Designated UST Operatar(O for this EgA!fty - - <br />19,11r, n '1144 <br />Dmpo!d Opmawes Nme- K2 ren R Aimak <br />Relation to US Facility (Check Om) <br />13 owner 13 Operator 0 Employee <br />Q Service Technician X Third -Party <br />Business Nam (Ifds <br />. ffawafrvm above)., <br />Designated operswes mae #,, (209) 518-48 6 <br />hitemwionA Code CDuacil Cerffication #- 8032295 -UC <br />Expiration Date: 06/20/2011 <br />JL <br />DewpAtod opavdor,3 Name. Rekdon to UST'Facility (Check One) <br />Busimm Name (,rf&ffemntfrm above): 0 Owncr 0 Opmwr 13 Employee <br />Dwhpuftd OpcMoes Phone #- 0 Service TwWcien TbW-PaM <br />#b1cme4onal code coumil catfficafion Zvkafion Data <br />"MOTA-MMITT177 �,,T <br />Designated Operator's Name: <br />Relation to UST Facilky (Check One) <br />C3 owner 0 OpemW 13 EMployac <br />0 Service TechdciaQ 0 lbiT&PwV <br />Bu mem Wme (Ifdiffemntfmm above): <br />Designated Opeames Phone s-, <br />bitemadonal Code Council Cerfift4ou <br />EXRWOA Date: <br />MM.Tait - raTil MOM. - =-.t - t 4 4 <br />Mis a 1 I.1 a.I aupli <br />Aw Mr. PAmrw,/.XA <br />mzm_ wIll 010 <br />1�[$4 V $8 IIZJ_lj .11Z I V W V A <br />I "T113 <br />2yf;llj,f T"171 =L11==7 U, k 'M i <br />OF THE CHANGE <br />RL =,- 11 71,211M, <br />