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(-eA — tel � fauk- s <br /> UndergroundCalifornia Environmental Reporting System(CERS) <br /> Information <br /> Facility/Site <br /> City gas and liquor CERS ID <br /> 16470 Cambridge Dr 10779784 <br /> Lathrop,CA 95330 <br /> Submittal Status <br /> Submitted on 1/11/2019 by AMARIIT KHINDA of City gas and liquor(Lathrop,CA) <br /> Submittal was Accepted;Processed on 1/14/2019 by Elena Monza for San Joaquin County Environmental Health <br /> Comments by regulator:This UST submittal was accepted by Elena Manzo,REHS,ICC Certified UST Inspector,on 1-14-2019. This acceptance is subject to verification <br /> t the next scheduled field inspection. <br /> ype of Action <br /> onfirmed/Updated Information <br /> Facility Information rank Operator <br /> ity gas and liquor NTERSTATE A ENTERPRISES INC <br /> 6470 Cambridge Dr 209)321-4134 <br /> Lathrop,CA 95330 16470 Cambridge Dr. <br /> acility Type Board of Equalization Account Number athrop,CA 95330 <br /> Motor Vehicle Fueling 44053368 <br /> s the facility located on Indian Reservation/Trust lands? <br /> 0 <br /> Property Owner rank Owner <br /> INTERSTATE A ENTERPRISES INC INTERSTATE A ENTERPRISES INC <br /> (209)321-4134 209)321-4134 <br /> 16479 Cambridge Dr. 16470 Cambridge Dr. <br /> Lathrop,CA 95330 athrop,CA 95330 <br /> rank Owner Type <br /> Non-Government <br /> Permit Holder Information <br /> ermit Holder Notification Information Supervisor of Division,Section,or Office(Required for Public Agencies Only) <br /> ank Owner <br /> Financial Responsibility Mechanism(s) <br /> Indicate 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 /> Self-insured Surety Bond State Fund and CFO Letter Other Mechanism <br /> Yes <br /> Guarantee Letter of Credit State Fund and CD <br /> Insurance Exemption Local Government Mechanism <br /> Printed on 1/14/2019 1:53 PM <br />