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California Environmental Rel3orting System (CERS) Underground Storage Tank-Facility Information <br /> Facility/Site <br /> VALERO CORNER STORE#3698 CERS ID <br /> 153 E ELEVENTH ST 10181331 <br /> TRACY,CA 95376 <br /> Submittal Status <br /> Submitted on 3/19/2013 by Nancy Coen of CST California Stations,Inc.(Hanford,CA) <br /> Type of Action <br /> Confirmed/Updated Information <br /> Facility Information I Tank Operator <br /> VALERO CORNER STORE#3698 CST California Stations,Inc. <br /> 153 E ELEVENTH ST (1800)441-4451 <br /> TRACY,CA 95376 685 W THIRD ST <br /> Facility Type Board of Equalization Account Number HANFORD,CA 93230 <br /> Motor Vehicle Fueling 44045933 <br /> Is the facility located on Indian Reservation/Tru lands? <br /> Na <br /> Property Owner Tank Owner <br /> CST California Stations,Inc. CST California Stations,Inc. <br /> (559)582-0241 (1800)441-4451 <br /> 685 W THIRD ST 685 W THIRD ST <br /> HANFORD,CA 93230 HANFORD,CA 93230-5000 <br /> Tank Owner Type <br /> Non-Government <br /> Permit Holder Information <br /> Permit Holder Notification Information Supervisor of Division,Section,or Office(Required for Public Agencies Only) <br /> Tank Operator <br /> Financial Responsibility Mechanisms) <br /> Indicate which approved mechanism(s)are bein used to show financial responsibility either as contained in the federal regulations(40 CFR,Part 280,Subpart H,Sections 280.93 <br /> through 280.107)or CCR,Title 23,Division 3,Chater 18,Section 2808.1. <br /> Self-Insured Surety and State Fund and CFO Letter Other Mechanism <br /> Yes <br /> Guarantee Letter f Credit State Fund and CD <br /> Insurance Exemp'on Local Government Mechanism <br /> Applicant Certification <br /> Applicant Name Applic2 it Title Applicant Phone Date Certified <br /> SANDY HUFF COMP IANCE COORDINATOR (559)583-3298 2/27/2013 <br /> Printed on 3/28/2013 7:31 AM <br />