Florida Department of Environmental Protection
Bureau of Petroleum Storage Systems
Facility Inspection Cover Page
Facility Information

District: CD Type: Fuel User/Non-Retail
County: Volusia Status: Open
Facility ID#: 9809154 Latitude: 29:17:18.0355
Name: Oceanside Executive Center Longitude: 81:02:20.0733
140 S Atlantic Ave #400 LL Method: DPHO
Ormond Beach, FL 32176 LL Status: REVIEWED
Contact: Starr Ford Ext 1451 Status Date: 11//12/2007
Phone: 386-677-4453

Account Owner Information
Name: Burt, Wallace L & Ann E Effective Date: 04/30/2007
140 S Atlantic Ave #400 Placard#/Date: 554860 - 06/04/2019
Ormond Beach, FL 32176
Phone: 386-677-4453

Tank Owner Information
Name: Burt, Wallace L & Ann E Effective Date: 04/30/2007
140 S Atlantic Ave #400
Ormond Beach, FL 32176
Phone: 386-677-4453

Tank
#		 Size Content Installed Placement Status Const Pipe Monitor
1 800 Vehicular Diesel
07/01/2007
ABOVE
U




***Note:   Construction, Piping, and Monitoring Info not shown
                   for CLOSED tanks (Status of A or B).

Most Recent Insurance Document
FR Type Effective
Date 		Expiration
Date 		Company Name
Insurance
07/11/2017
07/11/2018
  Crum & Forster Indemnity
Insurance
07/11/2014
07/11/2015
  American Safety Indemnity Co
Insurance
07/11/2011
07/11/2013
  American Safety Indemnity Co

No OPEN violations found!

No Discharge Information Found!


End of Data for Facility #: 9809154