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G1 <br /> ,on It I <br /> California Environmental Reporting System (CERS) Underground Storage Tank- Facility Information AV <br /> facility/Site <br /> CERS ID <br /> RCO 83680 10182237 <br /> 14931 N FLAG CITY BLVD <br /> ODI,CA 95242 <br /> ubmittal Status <br /> - <br /> ubmitted on 12/9/2014 by omritpa)wraith of ARCO 83680(LODI,CA) <br /> ubmittal was Accepted;Processed on 12/9/2014 by Ads Veloso for San Joaquin County Environmental Health <br /> Ype of Action <br /> 'New Permit <br /> facility Information Tank Operator <br /> RCO 83680 ODI OIL LLC <br /> 14931 N FLAG CITY BLVD 209)366-1414 <br /> ODI,CA 95242 4931 north flag city blvd. <br /> aciliq,Type Board of Equalization Account Number LODI,CA 95242 <br /> otor Vehicle Fueling 44050788 <br /> s the facility located on Indian Resertution/Tmst lands? <br /> 0 <br /> roperty Owner <br /> rank Owner <br /> odi oil tic ODI OIL LLC <br /> 209)366-1414 209)366-1414 <br /> 4931 north Bag city blvd. L4931 north flag city blvd. <br /> odi,CA 95242 ODI,CA 95242 <br /> ank Owner Type <br /> on-Government <br /> Permit Holder Information ., ' <br /> ermn Holder Notification Information pv Su c so i <br /> of Divalo ,Secno+,or Office(Rogmred f r R bba Agent e+0+ly) <br /> Faclhty Owner __ _ ......... .-...._- ---.... .-_-_ <br /> financial Responsibility Mechanisms) <br /> indicate which approved mechanlsm(s)are being used to show finnnc al respooabihty either as ccitined in the federal regutations{40 CFR,Part 280.Subpart H,Sections 280.93 through <br /> 60.107)or CCR,Title 23,Division 3,Chapter 18,Section 2808.1. <br /> elf4mured Surety Bond State Fund and CFO Letter Other Mechanism <br /> Yes <br /> Guarantee Letter of Credit State Fund and CO <br /> i sura s. Exemption Local Government Mechanism <br /> pplicant Certification <br /> ppl cant Name Applicant Title Applicant Phone Dam Certified <br /> MRITPAL S.WRAICH MANAGER (209)366-1414 12/2/2014 <br /> Printed on 12/9/2014 3:53 PM <br />