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COMPLIANCE INFO_1991-2004
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2300 - Underground Storage Tank Program
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PR0232534
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COMPLIANCE INFO_1991-2004
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Last modified
11/19/2024 10:19:32 AM
Creation date
6/3/2020 9:57:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1991-2004
RECORD_ID
PR0232534
PE
2361
FACILITY_ID
FA0004547
FACILITY_NAME
CHEVRON STATION #201383
STREET_NUMBER
1960
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23402001
CURRENT_STATUS
01
SITE_LOCATION
1960 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0232534_1960 W ELEVENTH_1991-2004.tif
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EHD - Public
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SECTION 1 <br />ENS <br />Jill NOTIFICATION <br />BUSINESS NAME APSI `CHEVRON <br />FACILITY STREET ADDRESS 1710 S. Corral Hollow Road <br />C= Tracy <br />ZIP 95376 <br />FACILITY TELEPHONE ( 209-) 836-3181 <br />MAILING ADDRESS CHEVRON USA PRODUCTS CO. P.O. BOX 5004 <br />CITY San Ramon CA ZIP 94583 <br />TFI.EPHONE ( 510 ) 842-9002 <br />(If di ffacnt fmm Company HeadTnrun) <br />LOCAL PRIMARY BUSINESS EMERGENCY CONTACT <br />11AME Skip Well <br />RESIDENCE1710 S. corralHollow <br />TELEPHONE (OFFICE) ( 209)- F-3181 (HOME) ( 209 ) <br />LOCAL ALTERNATE BUSINESS EMERGENCY CONTACT <br />NAME Josh Kruger <br />RESIDENCE 6601 Owens Drive,. Suite 155, Pleasanton, CA 94588 <br />TELEPHONE(OFFICE)(510 )__463-8373 (HOME) ( 510 )-25ti-ngtiti <br />24-HOUR ONSITE CONTACT Skip Well TELEPHONE( 209) 579-2718 <br />(ItAvaifable) _ <br />I declare under the penally of perjury that I have reviewed this entire Hazardous Materials Manage- <br />ment Plan and it is accurate to the best of my knowledge. I understand that false/inaccurate infor- <br />mation may contribute to complications during a hazardous material incident: This declaration is <br />made in the city of California. <br />0. � h A <br />NAME OFON-SITEMANAGER S Wel1S�j TITLE Manager . <br />awn _._.._...._.. <br />SIGNATUREOFON-SITEMANAGER <br />"'3- �� DATE <br />NAMEOFPERSON Kathy Norris <br />Responsible for the compktion or HrAW <br />SIGNATURE <br />(PROM <br />2 <br />71TLE HMMP Coordinator <br />DATE 12--- 13 _ ?:3 <br />
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