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(o) Eykk <br />i& g N131 <br />California Environmental Reporting System (CERS) <br /> <br />Underground Storage Tank - Facility Information <br /> <br />Facility/Site <br />Yosemite Avenue Arco AmPm <br />1711 E Yosemite Ave <br />Manteca, CA 95336 <br />CERS ID <br />10422475 <br />Submittal Status <br />Submitted on 11/17/2014 by Sharma Sharma of MAIN STREET ARCO AM PM* (MANTECA, CA) <br />Type of Action <br />New Permit <br />Facility Information <br />Yosemite Avenue Arco AmPm <br />1711 E Yosemite Ave <br />Manteca, CA 95336 <br />Facility Type Board of Equalization Account Number <br />Motor Vehicle Fueling 44050772 <br />Is the facility located on Indian Reservation/Trust lands? <br />No <br /> <br />Tank Operator <br />Jesse & Kul Petroleum, Inc <br />(209) 823-4715 <br />1711 E Yosemite Avenue <br />MantecA, CA 95336 <br />Property Owner <br />Jesse & Kul Estate Enterprise LLC <br />(925) 560-8386 <br />1782 N. Terracina Drive <br />Dublin, CA 95336 <br />Tank Owner <br />Jesse & Kul Petroleum, Inc <br />(209) 823-4715 <br />1711 E Yosemite Avenue <br />MantecA, CA 95336 <br />Tank Owner Type <br />Non-Government <br />Permit Holder Information <br />Permit Holder Notification Information Supervisor of Division, Section, or Office (Required for Pu blic Agencies Only) <br />Tank Operator <br />Financial Responsibility Mechanism(s) <br />Indicate 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 />280.107) or CCR, Title 23, Division 3, Chapter 18, Section 2808.1. <br />Self-Insured Surety Bond <br /> State Fund and CFO Letter Other Mechanism <br />Yes <br />Guarantee Letter of Credit <br /> State Fund and CD <br />Insurance Exemption Local Government Mechanism <br />Applicant Certification <br />Applicant Name Applicant Title Applicant Phone Date Certified <br />Kuldeep Sharma President <br /> <br />(510) 468-2371 <br /> <br />11/17/2014 <br />Printed on 11/17/2014 8:23 AM