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UNDERGROUND STORAGE TANK FACILITY EMPLOYEE TRAINING CERTIFICATE (Page 1 of 1) I. FACILITY INFORMATION Business Name(Same as Facility Name or DBA-Doing Business As) CERS ID A AND A GAS 10181235 Business Site Address City ZIP Code 16 E HARDING STOCKTON 95204 II. DESIGNATED UNDERGROUND STORAGE TANK OPERATOR INFORMATION Name of Designated UST Operator Providing the Training(Print as shown on the ICC Certification.) Edward Stearns Mailing Address Phone# 416 2nd Street Galt CA 95632 (209) 744-0112 ICC Certification# ICC Certification Expiration Date 8883080-UC 2/21/2022 III. FACILITY EMPLOYEE INFORMATION Individuals assuming the duties of the facility employee before October 13,2018 must be trained within 30 days of performing facility employee duties. Individuals assuming the duties of the facility employee on and after October 13,2018 must be trained before performing facility employee duties. ❑ Check this box if a list of the individual(s)trained is appended to this form. The appended list,at a minimum,must contain all of the information in this section. Date of Assuming Name of Individual(s)Trained Initial Training Date Responsibility as a Facility Employee IBRAHAM AYUBO 1/14/2022 1/14/2022 BALINDER KAUL 1/14/2022 1/14/2022 KAMRAH 1/14/2022 1/14/2022 WALLI 1/14/2022 1/14/2022 ABDUL LAMED 1/14/2022 1/14/2022 IV. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING THIS TRAINING The facility employees listed above have completed the required training in accordance with California Code of Regulations, Title 23, Division 3, Chapter 16, Section 2715(c)and all the information provided herein is accurate. Training Designated UST Operator Signature Date of Training 6¢-V-1-- 1/14/2022 CERS=California Environmental Reporting System,ID=Identification,ICC=International Code Council,UST=Underground Storage Tank