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Jeff Wong [EH] <br />From: Jeff Wong [EH] <br />Sent: Thursday, November 29, 2012 11:11 AM <br />To: 'ps1928@sbcglobal.net' <br />Subject: New owner consultation 130 Wilson <br />Attachments: CERS Flyer for Hazmat.pdf; CERS Lead User Authorization Blank Form SJC.doc <br />Mr. Singh: <br />As I explained over the phone, you might want to begin filling out some of the following forms ahead of time. While <br />these forms will be available during the consultation scheduled for next Tuesday at 9am, please be aware since the <br />consultation fee covers only one hour, any time over that length will be chargeable. The following forms can be found on: <br />http://www.sicehd.com/Programs/UnitIIl/ust.html <br />1. Underground Storage Tanks — Facility Form (a.k.a. the "A" Form) — Provide all current information, sign and date <br />at the bottom. <br />2. Underground Storage Tanks — Tank Forms (a.k.a. the "B" Form) — Provide all current information, sign and date <br />the bottom of each form. <br />3. Certification of Financial Responsibility/Letter from Chief Financial Officer: Complete the form provided, and <br />make a copy for our records. This document is required to be submitted to this office annually. <br />4. Underground Storage Tank Monitoring and Response Plans: Complete and submit a copy for approval. An <br />approved copy will be returned. Retain an approved copy of these plans onsite for future reference by employees. <br />5. Notification form identifying the "Designated UST Operator" for each facility owned. <br />The following information will also be required. <br />1. A permanent California EPA ID number. Fax application for EPA ID number to (916) <br />255-4703. The application form is available at this <br />address: http://www.dtsc.ca.gov/[DManifest/ID Numbers.cfm <br />2. Board of Equalization UST Storage Fee Account Number — Call (916) 322-9669 to <br />obtain a current number for this facility. <br />3. Please check with San Joaquin Valley Air Pollution Control District — Call (209) 557- <br />6400 for operating permit for vapor recovery system on the UST. <br />4. Pay transfer fee for the food facility permit and UST and Hazardous Waste (HW) <br />operator permit. Please bring the food consultation report the inspector had left with <br />you last week. <br />During the Tuesday meeting, I will also go over Best Management Practices (BMP's) for Retail Gasoline Outlets, and the <br />requirement to sign up for California Environmental Reporting System (CERS) by January 1, 2012. I have included an <br />information flyer, and an authorization form with this email which you will have to submit to us concurrent with applying <br />for a new CERS account. <br />Please call if you have any questions. <br />Best Regards, <br />