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M State Water Resources Control Board <br /> v Division of Financial Assistance <br /> 1001 1 Street • Sacramento, California 95814 <br /> Winston H, Hickox P.O. Boz 944212 • Sacramento, California • 94244-2120 <br /> Secretaryfor (916) 341 -5788 • FAX (916) 341-5806 • www.swreb.ca.gov/cwphome/ustef Gray Davis <br /> Environmental Governor <br /> Protection The energy challengefacing California is real. Every Caltftmian needs to take immediate action to reduce energy consumption. <br /> For a list ofshnple ways you can reduce demand and cut your energy costs, see our website at www.swrcb.ca.gov. <br /> 13 June 03 <br /> Apache Plastics, L.P. <br /> Larry Beasley <br /> 2120 Pebble Dr <br /> Alamo, CA 94502 <br /> UNDERGROUND STORAGE TANK CLEANUP FUND (FUND), REIMBURSEMENT REQUEST, CLAIM <br /> NUMBER: 001696, FOR SITE ADDRESS: 2050 FREMONT ST, STOCKTON <br /> Upon reviewing your Reimbursement Request No. 7 it was noticed that the following items were not submitted with your request. <br /> We cannot process your cleim any further until this infermation is received and verified by our staff. Please provide the following <br /> information: <br /> ❑ Reimbursement Request Form (USTCF-REQ) signed and dated in ink by the claimant or authorized representative. <br /> FNotarized Power of Attorney form signed and dated in ink by the claimant and designated attomey-in-fact. <br /> ❑ Non-Recovery From Other Sources Disclosure Certification (USTCF019.NON) signed and dated in ink by the claimant <br /> or the designated attorney-in-fact, including any applicable settlement/insurance documentation. <br /> Claimant Data Record (STD 204) signed and dated in ink by the claimant or authorized representative. <br /> ❑X Canceled checks from previous Reimbursement Request No. 6 as listed on enclosed Documentation Request. <br /> F] Other <br /> Mail the requested information to: <br /> Doug Tsuda Claim Number: 001696 <br /> State Water Resources Control Board <br /> Division of Financial Assistance <br /> 1001 I Street, 17' Floor <br /> P.O. Box 944212 <br /> Sacramento, CA 94244-2120 <br /> All of the above items must be properly documented, signed, dated and completed in order to continue processing your <br /> Reimbursement Request. Please provide the above information within 10 calendar days of this letter or we will return your <br /> reimbursement request unprocessed. <br /> If you have any questions, call me at (916) 341 -5788. <br /> Sincerely, <br /> Doug Tsuda <br /> Payments Unit <br /> Underground Storage Tank Cleanup Fund <br /> Enclosures <br /> Csiiiornis En vironments/ProteelieB A enc <br /> g y <br /> p4°d RecycldPaper <br />