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E <br /> ITTEN AGREEMENT BETWEEN UNDERGROUND STORAGE TANK <br /> RMIT HOLDER AND UNDERGROUND STORAGE TANK OPERATOR <br /> For use by Unidocs Member Agencies or where approved by your Local Jurisdiction <br /> ty Cited:California Health and Safety Code(HSC)§25284(a)(3); Title 23 California Code of Regulations§2620(b) <br /> In cases where the underground storage tank(UST)permit is issued to a person other than the operator of the UST(s),the permit holder <br /> must enter into a written agreement with the operator of the UST(s)which requires that the UST operator monitor the UST(s),maintain <br /> appropriate records, implement reporting procedures, and otherwise operate as required by the conditions of the permit issued by the <br /> local Unified Program Agency(UPA).Use of this form to satisfy this requirement is optional.You may use your own format provided <br /> that it satisfies the requirements of HSC §25284(a)(3).[Note: "UST Operator"means the person or organization that is in control of, <br /> or has responsibility for, day-today operation of the UST system(s), as distinguished from the "Designated UST Operator" who <br /> performs monthly facility inspections and training of facility employees pursuant to 23 CCR§2 71 5.1 <br /> A. FACILITY IDENTIFICATION <br /> FACILITY NAME CERS ID or Facility ID <br /> Tracy Shell 10181411 <br /> SITE ADDRESS <br /> 3725 N. Tracy Blvd. <br /> CITY ZIP CODE <br /> Tracy CA 95376 <br /> B.UNDERGROUND STORAGE TANK PERMIT HOLDER CERTIFICATION <br /> Certification:As the holder of the underground storage tank permit for the facility identified above,I hereby certify that: <br /> 1. I am(or represent)the individual,partnership,corporation or LLC,association,trust or government agency that is the holder of the <br /> UST permit for this facility,but I do not operate the UST(s). <br /> 2. I have provided to the UST operator a copy of the UST permit issued by the local UPA,which is attached to this written agreement <br /> and incorporated herein by reference. <br /> 3. I have provided to the UST operator a copy of the provisions of California Health and Safety Code Section 25299. <br /> 4. I understand that in order to be valid,this agreement must be signed by both the UST owner and the UST operator. <br /> 5. 1 understand that I am required to notify the local UPA of any change in UST operator by electronically submitting updated UST <br /> operator information and an uploaded PDF copy of a revised version of this agreement via the California Environmental Reporting <br /> System(CERS)website or an equivalent local UPA electronic reporting portal within thirty(30)days of the change in operator. <br /> UST PERMIT HOLDER NAME' <br /> Anabi Real Estate Dev., LLC <br /> NAME OF S NER(print) TITLE OF SIGNER <br /> Summer eifej Controller <br /> U!STM HOLDER SIGNATURE DATE SIGNED <br /> 1/25/2018 <br /> C. UNDERGROUND STORAGE TANK OPERATOR CERTIFICATION <br /> Certification:As the operator of the underground storage tank(s)at the facility identified above,I hereby certify that: <br /> 1. I am(or represent)the individual,partnership,corporation or LLC,association,trust or government agency that is in control of,or <br /> has responsibility for,day-to-day operation of the UST(s)at this facility. <br /> 2. I have received a copy of the UST permit issued by the local UPA,which is attached to this written agreement and incorporated <br /> herein by reference. <br /> 3. I have reviewed the provisions of California Health and Safety Code Section 25299 as detailed on page 2 of this agreement. <br /> 4. I understand that in order to be valid,this agreement must be signed by both the UST owner and the UST operator. <br /> 5. I understand that by signing this agreement, I become obligated to monitor the UST(s), maintain appropriate records, implement <br /> reporting procedures,and otherwise operate as required by the conditions of the permit. <br /> UST OPERATOR NAME' <br /> RADC ENT RISES INC <br /> NAME OF SIG print) TITLE OF SIGNER <br /> Summer Ir ' Controller <br /> UST OP IGNATURE DATE SIGNED <br /> 1/25/2018 <br /> * Legal name of individual,partners,corporation,LLC,LP,or other entity that is the UST permit holder or UST operator. <br /> UN-106 www.unidoes.org 1/2—01/04/16 <br />