ContractUnderground Storage Tank Owner/Operator Agreement • December 20th, 2020
Contract Type FiledDecember 20th, 2020OC CUPA 1241 E. Dyer Road Ste 120 Santa Ana, CA 92705 Tel: (714) 433-6000 Fax: (714) 754-1768 www:occupainfo.com U n i f i e d P r o g r a m C o n s o l i d a t e d F o r m UNDERGROUND STORAGE TANKS OWNER/OPERATOR AGREEMENT
ContractUnderground Storage Tank Owner/Operator Agreement • March 16th, 2020
Contract Type FiledMarch 16th, 2020El Segundo Fire Dept. Environmental Safety314 Main StEl Segundo, CA 90245 Tel: (310) 524-2242www.elsegundo.org U N I F I E D P R O G R A M C O N S O L I D A T E D F O R MUNDERGROUND STORAGE TANKS OWNER/OPERATOR AGREEMENT PART I: OWNER CERTIFICATION As the Owner of the underground storage tank system associated with the service station facility located at: I hereby certify:1. I am not the operator of the underground storage tank system located at the above-noted facility, and;2. I will provide the operator with a copy of the permit to operate the underground storage tank system at the facility, and;3. I have provided the operator with a copy of the provisions of Health and Safety Code Section 25299 as attached, and;4. I understand that I am required to notify the Underground Storage Tank Program of the El Segundo Fire Department, in writing, regarding any change of operator within thirty (30) days of the change, and;5. I understand that this agreement must be signed by both the owner
ContractUnderground Storage Tank Owner/Operator Agreement • December 14th, 2011
Contract Type FiledDecember 14th, 2011OC CUPA1241 E. Dyer Road Ste 120 Santa Ana, CA 92705Tel: (714) 433-6000Fax: (714) 754-1768www:occupainfo.com U N I F I E D P R O G R A M C O N S O L I D A T E D F O R MUNDERGROUND STORAGE TANKS OWNER/OPERATOR AGREEMENT PART I: OWNER CERTIFICATION As the Owner of the underground storage tank system associated with the service station facility located at: I hereby certify:1. I am not the operator of the underground storage tank system located at the above-noted facility, and;2. I will provide the operator with a copy of the permit to operate the underground storage tank system at the facility, and;3. I have provided the operator with a copy of the provisions of Health and Safety Code Section 25299 as attached, and;4. I understand that I am required to notify the Underground Storage Tank Program of the Orange County Health Care Agency, in writing, regarding any change of operator within thirty (30) days of the change, and;5. I understand that this agreement must be signed by both the