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kS� u Lit]111A 13 -I <br /> California Environmental Reporting System (CERS) Underground Storage Tank-Facility information <br /> Facility/Site <br /> Yosemite Avenue Arco AmPm CERS ID <br /> 1711 E Yosemite Ave 10422475 <br /> Manteca,CA 95336 <br /> Submittal Status <br /> Submitted on 11/17/2014 by Sharma Sharma of MAIN STREET ARCO AM PM"(MANTECA,CA) <br /> ype of Action <br /> New Permit <br /> Facility Information Tank Operator <br /> Yosemite Avenue Arco AmPm Jesse&Kul Petroleum,Inc <br /> 1711 E Yosemite Ave 209)823-4715 <br /> Manteca,CA 95336 1711 E Yosemite Avenue <br /> Facility Type Board of Equalization Account Number MarltecA,CA 95336 <br /> Motor Vehicle Fueling 44050772 <br /> Is the facility located on Indian Reservation/Trust lands? <br /> No <br /> Property Owner Tank Owner <br /> Jesse&Kul Estate Enterprise LLC Jesse&Kul Petroleum,Inc <br /> 925)560-8386 209)823-4715 <br /> 1782 N.Terracina Drive 1711 E Yosemite Avenue <br /> Dublin,CA 95336 MantecA,CA 95336 <br /> Tank Owner Type <br /> Non-Government <br /> Permit Holder Information <br /> ermit Holder Notification Information Supervisor of Division,Section,or Office(Required for Public Agencies Only) <br /> rank 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 /> 80.107)or CCR,Title 23,Division 3,Chapter 18,Section 2808.1. <br /> Self-insured Surety Bond State Fund and CFO Letter Other Mechanism <br /> Yes <br /> Guarantee Letter of Credit 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 (510)468-2371 11/17/2014 <br /> Printed on 11/17/2014 8:23 AM <br />