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t <br /> CHEVRON#208117** CERS ID <br /> 755 S TRACY BLVD 10182313 <br /> RACY,CA 95376 <br /> i j s <br /> Submitted on 3/31/2015 by Charles Bittle of Chevron Products Company(A Division of Chevron U.S.A.Inc.)(San Ramon) <br /> Comments by submitter:Per the request on the 2/23/2015 UST Inspection report,I am resubmitting the UST element with revised forms.If you have questions or if <br /> further action is necessary,please contact Charles Bittle at cbittle@chevron.com or call 925-842-9002. <br /> -77 <br /> tY-nfirmed/Updated <br /> ��a Ac'fit©n '''� m � -.,Information <br /> acuity Infdr i+ tiortn�c ?#�eratr'�, <br /> N u, 41 :'. <br /> CHEVRON#208117** CHEVRON PRODUCTS COMPANY(A DIVISION OF CHEVRON U.S.A.INC.) <br /> T755 S TRACY BLVD 925)842-9002 <br /> RACY,CA 95376 P.O.BOX 6004,ATTN:PERMIT DESK <br /> Facility Type Board of Equalization Account Number SAN RAMON,CA 94583 <br /> Motor Vehicle Fueling 44031913 <br /> s the facility located on Indian Reservation/Trust lands? <br /> ,� x C <br /> roperw QWneC ': ✓i.,,,i , „ ,. „,. i,'', an1S W11er i i!;,, Us <br /> PEPPER LANE MONTEREY ROAD L L C C/O BORELLI INVESTMENT CO CHEVRON PRODUCTS COMPANY(A DIVISION OF CHEVRON U.S.A.INC.) <br /> (408)453-4700 925)842-9002 <br /> 980 HILLSDALE CIR STE A P.O.BOX 6004,ATTN:PERMIT DESK <br /> L DORADO HILLS,CA 95762 SAN RAMON,CA 94583 <br /> Tank Owner Type <br /> Non-Government <br /> Permit Holder infoll nation° <br /> Permit Holder Notification information Supervisor of Division Section,or Office(Required for Public Agencies Only) <br /> Tank Owner <br /> tn` is.< <br /> anccal Respc>nibitity M� ini�m�s) = _ .. + .. <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 /> 80.167)or CCR,Title 23,Division 3,Chapter 18,Section 2808.1. <br /> iPen-Insured Surety Bond State Fund and CFO Letter Other Mechanism <br /> uarantee Letter of Credit State fund and CD <br /> Yes <br /> Insurance Exemption Local Government Mechanism <br /> i i. i� j <br /> pant Certification <br /> Applicant Name Applicant Title Applicant Phone Date Certified <br /> CHARLES BITTLE RETAIL HES (925)842-9002 2/3/2014 <br /> Printed on 3/31/2015 6:51 PM <br />