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U N D ERG ROU NO STOR AGE TANK <br /> FACILITY EMPLOYEE, TRAINING CERTIFICATE Rage iaryI <br /> I. FACII IT`Ir INFORMATION <br /> 13uslrsess fame r,13Nfrte qs FaOft rvwrie or oj�A-z�ouo-g ausvress pial_ Com$ID <br /> _JD Service Station, Inc. 1 D443520 <br /> 9uslnes.�S+[e Adp.r�s6 ZIP Gads <br /> 9015 Walnut Grove Rd74iomten 95686 <br /> JI. DESIGNATED UNDER ROUND STORAGE TANK OPERATOR INFORMATION <br /> Name Py Uasigratad UST Operainr PrcvidMg the Tralninj� rP�;nt as shown art rtm?DF,ceft,l;ralron.w <br /> Epic Meeker <br /> Mailing Address Phone 9 <br /> 1533 inn sort Ave _ 5� 960-117 <br /> ICO Cenlficatinn 7C C=rsincanan EFpirziom Dale <br /> 542511-UC; <br /> rII. FACILITY EMPLOYEE INFORMATION <br /> Individuals assuming the duties of tha taclitty employee before OaWber 73. 2oi a must he trained within 30 days Of Performing <br /> faeltlty emprojmg fmies.I ndMdu a Is assuming rhe dufles of the facility employee ort and after October 13, 2018 must be tra{net] <br /> before perlbrmillg faieillty emptoyee duties. <br /> Chock title ba]t lfa Hsi of the lndfvldualfa}tralned is aPper ded ro th is farm- Th a apperrafecf Ifs[, at a rnlnlmum,must r<onrain <br /> all of rhe ml'arMadan In Ihls secrign. <br /> — - - - _ dale tit Assuming <br /> Flame of Indlyidual(s)Trainod hiltlal Traifaing Date Respon!O[Altyasa <br /> Facility Employee <br /> Ramzan Neeem 312912019 3129!2019 <br /> Mohammed Furan X12512022 3!2512022 <br /> herban Khan 312512019 312912019 <br /> Usman Ail 312912019 -3!2912019 <br /> Blanca Sanchez 3129/20114 312912019 <br /> Nasin Tarin 31112010 3111241 D <br /> I <br /> I Y � <br /> I <br /> _ I <br /> Iv. CERY1FICATION BY DESIGNATED UST OPERATOR CONDUCTING THIS TRAINING <br /> The facility employees listed above b2lve completed the req ltired trainJng In accordance with Caltilom.is Code o`Rlggulatjonsr <br /> Tltle$3, 1)IV15ton 3,(;haptor 16,Section 271 5(c)and all the infar;,atlon provided herein is accw'atE. <br /> Training grraud UST Op:ratRr SlgnaWre DaS�of*r�an�ng <br /> 312412023 <br /> RS=Callfrrm E70rmmentEj Rep]rtlng Syztem,ID=V1u*R2r1kn ICC=lr arsal Ouide C,awrd,U T=Univ7wrid SVragearlk <br />