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UNDERGROUND STURAGE TANK <br /> FACILITY EMPLOYEE IRA I;KING GE RTI FICATE�P qe 1 of t) <br /> I. FACILITY MFGRMATION �+ <br /> Bu9iflt59a Nerve f Shrla$B Ffi!'�1hD'i4a'�^or A9,9-0aA,p 611S,wi9ss RS I10As.) CA <br /> 76 Express Mark 110182157 <br /> Bus[I9s9 Silk:Mdrew ZIR;.ade <br /> 5777 S. French Camp Rd French Camp 95231 <br /> u_ DESIGNATED UNMRGROUNo STCPAGE TA14K OPERATOR INFORMATION <br /> NarneotL?9algnalt�dUSTOpenatarf uidmytieTraMing{Prieras ixxsriOw!1791C0G-fiff—h—i-,l <br /> Alex A. Jabbad <br /> Rulllrp ASU mss PI artie� <br /> 537 Amherst Court,San Ramon_-CA 94583 � (025)389. 1262 Ext <br /> ICC 0BM#Cdtgn# ICC Crdifirzliotl Expiratian bw <br /> 5.243.897-U 1411 X2024 <br /> 11I, FACILITY EMPLOYEE iNFORMATION <br /> ihdiVidllalr oaun!ing ee daries of the Facility emplofw gore octod9r13.2019 mwtde Welded within 34 dbys of perfonninUF&C14 <br /> am ployee du4es. IndivWmlda masulning thr..d Lrbet Of W9 11*01ity arnpkoyte-og and Rfmr Oobober 13.2018 must be ivaitYed befam perffi�ng <br /> faellrry employee dUllea, <br /> chock ibis bay efemvofthe iodirWLm4s)tramedis,appentfedtothkform. ThedoW�emd4dL'slEdBiajtFANf11PF�ro{rft�nnlallFaRoftlw <br /> ffJrF}r17FBt�0+'in ahi.?seG�OY1. <br /> Iniial TMIRrnp OR7R ❑aLe of Assuming <br /> NRmo qF Indiwhlusll$i f rslnsd Rcspongihillty an a <br /> FeoAty Ernplpy, <br /> Sum2rl SElt9a 3�19f19 2415 <br /> An mal Ghat 311909 2416 <br /> Robio Singh 3119!19 2417 <br /> Isha Tiwari {igJi$ 2017 <br /> Harpreet Singh 3f19f19 2018 <br /> Randeep Kaur 3I19f79 2418 <br /> BalvirSing h 3flwl9 2016 <br /> 1v_ CERTIFICATION BY bESIGNATE D UST OPERATOR CONDUCTING T1iI5 TRAINING <br /> The tacifity cmaWe m-a Mesad aboyoC have completed the r4�rtulred!raining in aeebedance with Caglornis Code of Reguliatiort*, <br /> title 23,05%?W-sn 3,o1113pt4r 1B.Vection 2715X?and all the InformatiorF prrtwlde"rein ie accurato. <br /> framing cosignfflt�R U5'r Operel4r�nabure 1 � $imnq <br /> �{�=Caliianiia EiY•7onrn ental J2ctnortirry 3y apit155.ID=illnrhfir�tion,ICC-h 718rM1Nkrul Cndr Cb wail,U3T=lll►.79r$Gitrxi storage 65i7k <br />