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SITE INFORMATION AND CORRESPONDENCE FILE 2
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3500 - Local Oversight Program
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PR0544595
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SITE INFORMATION AND CORRESPONDENCE FILE 2
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Last modified
6/24/2019 10:36:12 AM
Creation date
6/24/2019 9:53:38 AM
Metadata
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Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 2
RECORD_ID
PR0544595
PE
3528
FACILITY_ID
FA0002048
FACILITY_NAME
TESORO (Shell) 68221(WRR 6290)
STREET_NUMBER
2705
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12121008
CURRENT_STATUS
02
SITE_LOCATION
2705 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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Palisades Gas &Wash -4- <br /> On page seven (7) of your claim application, Claimant must provide an "original <br /> signed" Verification and Signature Page including signatory's title as related to the <br /> claimant (see enclosed Verification and Signature page). C. Miller signed this page <br /> and you provided an Authorized Representative Designation Form signed by C. <br /> Miller; however, it is unclear as to C. Miller's affiliation with claimant and is form is <br /> no longer accepted by the Fund (see enclosed Authorized Representative <br /> Designation Form Replacement). <br /> In the past the Cleanup Fund allowed claimants to designate a representative to sign <br /> certain Fund documents. However, there is a concern that this procedure is not <br /> consistent with section 25299.55 of the Health and Safety Code, which requires a <br /> Fund claimant to make a sworn verification of the claim and certification of costs. <br /> Therefore, the "Authorized Representative Designation Form" is no longer being <br /> used by the Fund and we will not accept any future documents signed by the <br /> representative that was designated by such form. <br /> We encourage claimants to sign all Fund documents personally. However, there <br /> may be circumstances where a claimant wants a representative to be able to sign <br /> Fund documents on the claimant's behalf. In this situation, the claimant must <br /> submit a notarized Power of Attorney form designating a specific representative <br /> to sign and submit documents to the Fund on the claimant's behalf. The designated <br /> representative should not be a consultant or contractor performing work on the <br /> project site because it would create a conflict of interest. <br /> Claimants should be aware that they will be personally responsible and bound by <br /> any assertions made to the Fund pursuant to a Power of Attorney. (An appropriate <br /> Power of Attorney form-enclosed-is available on our web site or by request, however <br /> other forms may also be acceptable.) <br /> • Claimants who acquire sites after January 1, 1990, must complete the enclosed <br /> Claimant Certification of Compliance with Fund Regulations Section 2811(a)(1)-(2) <br /> and Health & Safety Code, Section 25299.54, subdivision (h). <br /> AND <br /> • Provide a copy of the first permit to own or operate the UST from the local <br /> implementing agency issued to you ("eligible claimant") and dated after you acquired <br /> site (11/97) (pursuant to Chapter 6.7 of the Health and Safety Code). You provided <br /> a permit issued to New West Petroleum dated 1/1/98-12/31/98. <br /> • Submit a removal permit for all underground storage tanks listed in claim application. <br /> • Claimant is required to provide documentation that all current and prior UST fees <br /> due on or after January 1, 1991 imposed by Section 25299.41 of the Health and <br /> Safety Code have been paid. If any of the USTs owned or operated had product <br /> California Environmental Protection Agency <br /> P.a R".vc%d Paper <br />
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