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State Water Resources Controo <br /> and e.. <br /> Division of Financial Assistance o <br /> 1001 1 Street•Sacramento,California 95814 *' <br /> - Alan C.Lloyd,Ph.D. P.O.Box 944212•Sacramento,California•94344-2120 <br /> Agency Secretory g u'P <br /> (916)341-5784•FAX(916)341-5866# www.waterboards.ca. ov/c home/ustef D Arnold Schwarzenegger <br /> LEo� <br /> Lu) <br /> September 12, 2005 !I SEP <br /> ENVIRONMFiV I-HEALTH <br /> d RERM,IT/SER VICES <br /> f - <br /> Valley Water Treatment <br /> 6520 Crosswods Circlei. <br /> Citrus Heights, CA 95621 <br /> _ . <br /> UNDERGROUND STORAGE TANK CLEANUP FUND(FUND)i, REQUEST FOR FURTHER <br /> DO�U1Vi l�FA'IIONTUR�NG'II IIIAI R V�EwCLAIIVI DUMBER 6-i 449; FOR SITE <br /> I ADDRESS: 612 BUENA VISTA AVE N, STOCKTON <br /> I� <br /> After reviewing your claim application to the Cleanup Fund,we find thatithe following additional <br /> information is needed to determine your eligibility for placement oil the Priority List: <br /> Priority Class "B" small business is for those businesses that are inldepend'ently owned and operated,not <br /> dominant in its field of o eration and employs 100 or less em la ees lncludin all affiliates and <br /> P P Y P Y . g , <br /> averages annual gross receipts of$10 million dollars or less over the previous three years. If a business is <br /> I. a manufacturer, there is no revenue test. However, the manufacturer must;also employ 100 or less } <br /> employees including affiliates. <br /> II <br /> If you believe that you qualify,you may request the Fund review your claim to determine eligibility for <br /> Priority Class "B". In order to determine eligibility, the following documents must be submitted and <br /> reviewed: <br /> • Complete the Enclosed form "Request for Assignment of Claim to Priority Class B". II <br /> AND <br /> • Submit the 2002 and 2003 years of complete federal tax returns. <br /> AND <br /> • Submit documentation supporting the number of employees for:the claimant, claimants business and <br /> any affiliates(i.e.Department of-Elnptoyment Development(D E6)payroll reports for the last four`-- <br /> r quarters). <br /> • The tax identification number on the submittedclaim application differs from the employer <br /> identification number listed on the 2004 tax return. Please explain. <br /> 0 The claimant name on the submitted claim application differs from the name listed on the 2004 tax <br /> return. Please explain. <br /> a Claimant must identify who owned the UST. Page three of thesubmitted application. Please <br /> complete and return. <br /> California Environmental Protection Agency <br /> t <br /> y �� Recycled Paper it i i <br />