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Nest Chevron <br />W Kettleman Ln <br />E Q Code ) <br />101,441/7 \ <br />Dba3?3'� C \\a\� <br />CERS ID <br />10748068 <br />Iu <br />bmittal Status <br />bmitted on 30/18/2017 by Fobiolo Padillo of Sunwest Chevron (Lodi, CAI <br />bmittal was Accepted; Processed on 10/18/2017 by Garrett Backus for San Joaquin County Environmental Health <br />mments by regulator: This UST submittal was accepted by Garrett Backus, REHS, ICC Certified UST Inspector, San Joaquin County Environmental Health Department <br />ar4nc0a irphd rnm The IIST infarmatinn will be verified durine the neat EHD Insoection. <br />ity Information <br />est Chevron <br />W Kettleman Ln <br />CA 95242 <br />Board of Equalization Account Number <br />Fueling 44052531 <br />ited on Indian Reservation/Trust lands? <br />terty Owner <br />LODI III LP <br />1753-7129 <br />I PARKSIDE DR. <br />NUT CREEK, CA 94596 <br />I Operator <br />Investments Inc. <br />753-7129 <br />Chiles Rd <br />„CA 95618 <br />I Owner <br />Investments Inc. <br />753-7129 <br />CA 95618 <br />lermit Holder Information <br />sermit Holder Notification Information Supervisor of Division, Section, or Office (Required for Public Agencies Only) <br />rank Owner <br />Financial Responsibility Mechanisms) <br />ndicate which approved mechanism(s) are being used to show financial responsibility either as contained in the federal regulations (40 CFR, Part 280, Subpart H, Sections 280.93 through <br />80.107) or CCR, Title 23, Division 3, Chapter 18, Section 2808.1. <br />elf -Insured Surety Band State Fund and CFO Letter Other Mechanism <br />Yes <br />uarantee Letter of Credit State Fund and CD <br />nsurance Exemption Local Government Mechanism <br />Printed on 10/24/2017 11:01 AM <br />