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GI <br /> California Environmental Reporting System (CERS) Underground Storage Tank-Facility Information AV <br /> Facility/Site <br /> ERS ID <br /> ARCO 83680 10182237 <br /> 4931 N FLAG CITY BLVD <br /> ODI,CA 95242 <br /> utimittalStatus <br /> ubmitted on 12/9/2014 by amritpa)wraich of ARCO 83680(LODI,CA) <br /> ubmittal was Accepted;Processed on 12/9/2014 by Ar Veloso for San Joaquin County Environmental Health <br /> ype of Action — <br /> New Permit <br /> acility Information , . Tank Operator <br /> RCO 83680 LODI OIL LLC <br /> 14931 N FLAG CITY BLVD 209)366-1414 <br /> ODI,CA 95242 14931 north flag city blvd. <br /> acillty Type Board of Equalization Account Number LODI,CA 95242 <br /> Motor Vehicle Fueling 44050788 <br /> s the facility located on Indian Reservation/Trust lands? <br /> o <br /> .roperty Owner rank Owner <br /> odi oil llc WI OIL LLC <br /> 209)366-1414 209)366-1414 <br /> 4931 north flag city blvd. L4931 north flag city blvd. <br /> odi,CA 95242 ODI,CA 95242 <br /> ank Owner Type <br /> on-Government <br /> ermit Holder Information <br /> ermit Halder Nobhcabo I,fo.n1abon Supe sof of Division Secbon,or Office(Required for Pubic Agenc,0 ly) <br /> acility Owner <br /> ------ <br /> Financial Responsibility Mechanism(s), tiYtpi a,„ <br /> ndicate which approved mechanismis)are being used to show financial revpansib la,either as contained in the federal,e&.ions(40 CPR,Part 280 5ubpart H,Sections 280.93 through <br /> 10.107)or CCR,Title 23,Division 3,Chapter 18,Section 2808.1. <br /> B-Insured Surety Bond State Fund and CFO Letter Other Mechanism <br /> Yes <br /> uarantee Letter of Credit State Fund and CO <br /> insurance Exemption Local Government Mechanism <br /> Applicant Certification. - <br /> �IApplkc rt Name Applicant lisle Applicant Phone Date Certified <br /> AMRITPAL S.WRAICH MANAGER (209)366-1414 12/2/2014 <br /> Printed on 12/9/20143:53 PM <br />