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COMPLIANCE INFO_2013-2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231488
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COMPLIANCE INFO_2013-2018
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Last modified
8/12/2021 12:06:22 PM
Creation date
6/23/2020 6:49:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2013-2018
RECORD_ID
PR0231488
PE
2361
FACILITY_ID
FA0003910
FACILITY_NAME
H&M - BW #98
STREET_NUMBER
2501
STREET_NAME
JACKSON
STREET_TYPE
AVE
City
ESCALON
Zip
95320
CURRENT_STATUS
01
SITE_LOCATION
2501 JACKSON AVE
P_LOCATION
06
P_DISTRICT
005
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231488_2501 JACKSON_2013-2018.tif
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EHD - Public
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rrepare Draft Submittal CE Busuiess <br />California Environmental Reporting System: Business <br />• <br />Page 1 of 2 <br />ROHDA—nLMttr"s.A C= Slan ot, TQ015 ggj= N."It <br />Home Submittals Facilities Compliance My Business <br />Prepare Draft Submittal: KWIK SERVE (B&W PETROLEUM) <br />Nome )) Prepare submittal (10191511) <br />_ InstructiorsHelp <br />Use this page to prepare draft submittals for your facility to transmit to your locai regulator(s). Make sure to review any status and guidance messages for your forms or submittals <br />by selecting the guidance icons' � 0. <br />• Select'Start' button to create a submittal from scratch or copied from a previous submittal. <br />• Select "New' and "Edit' buttons to complete specific submittal forms or provide supplemental documentation. <br />• Select "Discard" button to delete a draft form/documentation when you need to re -start a form or Nis no longer relevant for your draft submittal. <br />• <br />Select 'Not Applicable' if you believe the submittal element is no longer relevant for your facility (e.g., closed UST tank). <br />Select "Submit' when you are ready to transmit one or more submittals to your local regulator(s). ALL submittals must include a Facility Information element. <br />If there has been NO CHANGE in the HMBP submittal elements (Facility information, Hazardous Material Inventory, and Emergency <br />Response/Training Plans) since the last submittal, you may select the following button to prepare them. <br />Cxeate All HMBP Submittal Elements <br />Facility Infofmation <br />FTj Business Actisd(ies <br />Business Owner/Operator Identification <br />Hazardous Materials Inventory <br />HUSWOUS Material Inventory (3) <br />( Site Mao (Official Use Onlv17 Upload Documents) ta <br />Emergency Response and Training Pians <br />Emergency Response/Contingency Plan: Uoload Documents) (4) <br />120 Employee Training Plan: Stored at Fa itity <br />Underground Storage Tanks <br />F. UST Facility Operating Permit Application <br />0 Tanks <br />UST Tank InformationlMonitoring <br />Pian - Tank ID # TA0507895 (91 - 6K) <br />( UST Tank InformationlMoniioring <br />Plan - Tank ID # TA0507896 (Diesel - 6K) <br />F UST Tank Information/Monitoring <br />Plan - Tank ID # TA0507897 (87 12K) <br />UST Certifications of Installation/Modification <br />E <br />Ly UST Monitoring Site Plan: Upload <br />Documents) F <br />CV UST Certification of Financial Responsibility: <br />Upload Document(s) (2) <br />UST Response Plan: Upload Documents) <br />(2) <br />$ UST Owner/Operator. Written Agreement: <br />Exempt <br />f+ UST Letter from Chief Financial Officer: <br />Upload Document(s) (2) <br />tj Owner Statement of Designated UST Operator Compliance: Upload Documents)} <br />Veexron 2 22.R; 75 ; Enha•n:enrents l CERS Cenh al <br />ACCEPTED Aug. 11, 2014 Start 01 Not Applicable <br />ACCEPTED Jun. 27, 2014 Start "; Not Applicable (—*., <br />ACCEPTED Jun. 27, 2014 start ri Not APO.Cable s. <br />ACCEPTED Aug. 11, 2014 Start 19 Not Applicable 15 <br />Caktorrpa Enmenmetual Rerrortirg Sy�em. 0u5ness t iS 201 a Ca6torrtia Env+:arurarntal Pr�lecben A+3ency <br />CERS Technical Suppari. Raw" Tecteamt Asj4iiim <br />uWAed PmgratrVGlneral Assistance'. Contort yctxr reaulacortat <br />- et0 F-41Settings µ _.My Business: Ktk1K SERVE (B& W' RETROLFlJMj t�.c�etett BUStneS3 4 <br />https:Hcersbusiness3.calepa.ca.gov/49846/Facility/ 10181511 /DraftSubmittals 8/21/2014 <br />
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