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COMPLIANCE INFO_2021
EnvironmentalHealth
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2800 - Aboveground Petroleum Storage Program
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PR0539001
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
11/19/2024 10:19:35 AM
Creation date
7/6/2021 1:58:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2800 - Aboveground Petroleum Storage Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0539001
PE
2832
FACILITY_ID
FA0022384
FACILITY_NAME
Eleventh Street Chevron
STREET_NUMBER
7501
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
Tracy
Zip
95304
APN
25014017
CURRENT_STATUS
01
SITE_LOCATION
7501 W ELEVENTH ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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AUG/17/2021/TUE 02:23 PM <br />Tracy Truck Stop <br />10509463 <br />Buslneae Name (Same as Facility Name or DBA -Doing Business AS) <br />CJS CHEVRON <br />business Site Address <br />750 W ELEVENTH STREET <br />+n.nm.,,,.w.,, <br />nm:0jMM, L"sml yd i im 1 ilin.mnm��w `` "�± <br />N .,w o.mmm�kn ,� r'll�..,°.Fni�nme`I7 1nfl. UT <br />Name of Designated UST Operator (Print as shown on <br />David Winkler <br />88$3059 -UC <br />Al answers of "N" or IVA"in sections V11 through <br />1. AST TANKS <br />2. SECTIQN VIII NQ ALARMS <br />3. <br />C <br />5. <br />6. <br />7. <br />FAX No,209832 2312 <br />must be explain®d in th/s section <br />P, 012 <br />of Designated UST Operat <br />8/27/2019 <br />0 <br />ZIP Code <br />95304 <br />209) 744-0112 <br />�lration Date <br />2/23/2020 <br />may require follow-up a <br />12. SITE NOT REQUIRED TO HAVE TANK /LINE/SPILL BUCKET / OVERFILLG <br />m6Oa;�nM�uitu,Yiuyl CI I"181�m"waraur, maw��_, x�..�,a.. m.,,v. / . SECQNDARY TESTING AST TANKS <br />D vision 3ChKapterl6h <br />, Secrtioni2716 and all the 111 ink tion provided herle n s cctura allfornia'Code of Regulations, Title 2 <br />Designated UST Operator Signature (� 1 <br />AUlssues listed fn Section 11/above must have s descri tion of the fo W .,.,_..,.. ,nan�,,,,w,,...T ���w,n,�l„,_.rhl�'�P.N <br />r i imnWni 49�nmn nm,vMplai°l9ne <br />line that corresponds with thv number line of fhe comp/lance issUo 1/steduaboveoin Section 1Il.be taken to correct the issue on fhe <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />S. <br />9. <br />10. <br />11. <br />12. <br />f have reviewed Section III "COMPLIANCE ISSl1E3” and provided a description in Section V of fhe action taken or to be taken <br />to correct the Issues discovered. <br />Name of UST Owner/Operatpr (Print) UST Owne"Uperrator Signature Date Signed <br />CER5 � Callfotpla Environmental Repotting System, ID = Idenlifinttoh, UST � Underground Storage Tank, ICC O International <br />Coda Coundl <br />Received Time Aug, 1/, 2021 3:19PNM No. 6863 <br />
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