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COMPLIANCE INFO_2002-2005
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231094
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COMPLIANCE INFO_2002-2005
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Last modified
11/23/2020 2:10:05 PM
Creation date
6/23/2020 6:42:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2002-2005
RECORD_ID
PR0231094
PE
2361
FACILITY_ID
FA0003632
FACILITY_NAME
AJS MINI MART INC
STREET_NUMBER
7906
Direction
N
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95207
APN
07935016
CURRENT_STATUS
01
SITE_LOCATION
7906 N EL DORADO ST
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231094_7906 N EL DORADO_2002-2005.tif
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EHD - Public
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by • <br /> 0 <br /> BP West Coast Products LLC <br /> 4 Centerpointe Drive <br /> La Palma,CA 90623 <br /> Owner Statements of Designated Underground Storage Tank (UST) <br /> Operator <br /> and Understanding of Compliance with UST Requirements <br /> Facility Name: 2130 Facility ID#: 2130 <br /> Facility Address: 7906 N EL DORADO ST <br /> STOCKTON CA 95210 Reason for Submitting this Form(Check One) <br /> Facility Phone#:209-957-2987 X Change of Designated Operator <br /> ❑ Update Certificate Expiration Date <br /> Designated UST Operator(s) for this Facility <br /> PRIMARY <br /> Designated Operator's Name:Brian Ellsworth Relation to UST Facility(Check One) <br /> Business Name(If different from above):Delta Environmental Consultants,Inc. ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:916-524-6974 ❑ Service Technician X Third-Party <br /> International Code Council Certification#: 5263224-UC Expiration Date:2007-07-07 00:00:00 <br /> ALTERNATE 1 O tional <br /> Designated Operator's Name:refer to backup document Relation to UST Facility(Check One) <br /> Business Name(If different from above): ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:refer to backup document ❑ Service Technician X Third-Party <br /> International Code Council Certification#:refer to backup document Expiration Date:refer to backup document <br /> ALTERNATE 2 (Optional) <br /> Designated Operator's Name:refer to backup document Relation to UST Facility(Check One) <br /> Business Name(If different from above): ❑ Owner ❑ Operator ❑ Employee <br /> Designated Operator's Phone#:refer to backup document ❑ Service Technician X Third-Party <br /> International Code Council Certification#:refer to backup document Expiration Date:refer to backup document <br /> I certify that, for the facility indicated at the top of this page, the individual(s) listed <br /> above will serve as Designated UST Operator(s). The individual(s)will conduct and <br /> document monthly facility inspections and annual facility employee training, in <br /> accordance with California Code of Regulations, title 23, section 2715(c) - (f). <br /> Name of tank Owner(print): Chris Moul <br /> Signature of Tank Owner: ZG <br /> Date: 8/30/2005 Owner's Phone# (714) 690-2349 <br /> In December 2004,BP West Coast Products,LLC submitted a separate letter to the <br /> local agencies documenting compliance with UST regulations. A copy of this letter <br /> can be made available upon request. <br />
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