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1 <br /> UNDERGROUND STORAGE TANK (UST) <br /> OWNER / OPERATOR AGREEMENT <br /> T ER• <br /> As the ON ner of the underground storage nks,I, ertify <br /> I (01vNFR'S NAVE) <br /> thatELL een rotii ed a copy of the monitoring and <br /> (OfE TOR'SNAME) S �j� <br /> reporting requirements contained in Title 23, of thL alifornia Code of Regulations. <br /> I, ILVAiA4-zv1,rJI also certify that �i� �W411has been <br /> (OWNER'S NAME) # ( ERATOR'S N ) E) <br /> provided a copy of the penalties for noncompliance as specified in Se tion 25299, <br /> chapter 6.7, of the California Health a d Safety Code. <br /> SIGNATURE: l DATE: <br /> PRINT NIAME: C) D <br /> UST OPERATOR: <br /> As operator of the underground storage tanks,I hereby certify that I understand the <br /> monitoring and rep orti�_&requi ments contained in Title 23, of the California Code <br /> of Regulations and I.hAve received a cop Section 25299,Chapter 6.7, of the <br /> California Healt and Safety Code. <br /> SIGNATURE: DATE: <br /> PRINT NAME: <br /> DBA NAME: <br /> OPERATOR NAIVE: <br /> LOCATION: C"\3\ <br /> 715107 <br />