SITE INFORMATION AND CORRESPONDENCE

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copy STATE WATER RESOURCES CONTROL BOARD DIVISION OF CLEAN WATER PROGRAMS UST LOCAL OVERSIGHT PROGRAM NOTICE OF REQUIREMENT TO REIMBURSE SITE CODE: 1631 DATE FIRST REPORTED: 09/19/92 SITE NAME: JACKPOT FOOD MART SUBSTANCE: 8006619 ADDRESS: 14000 E HWY 88 PETROLEUM: Y CITY: LOCKEFORD STATE: CA zip: 95237--9703 The following information has been provided to: RESPONSIBLE PARTY: JACKPOT FOOD MART CONTACT: RANDY & DAWN HAYWOOD ADDRESS: 14000 E HWY 88 CITY: LOCKEFORD STATE: CA zip: 95237-9703 The federal Petroleum Leaking Underground Storage Tank Trust Fund (Federal Trust Fund) provides funding to pay the local and state agency administrative and oversight costs associated. with the cleanup of releases from underground storage tanks. The Legislature has authorized funds to pay the local and state agency administrative and oversite costs associated with the cleanup of releases from underground storage tanks. The direct and indirect costs of overseeing removal or remedial action at the above site are funded, in whole or in part, from the Federal Trust Fund. The above individual(s) or entity(ies) have been identified as the party or parties responsible for investigation and cleanup of the above site. YOU ARE HEREBY NOTIFIED that pursuant to Title 42 of the United States Code, Section 6991b(h) (6) and Sections 25297 . 1 and 25360 of the California Health and Safety Code, the above Responsible Party or Parties must reimburse the State Water Resources Control Board not more than 150 percent of the total amount of site specific oversight costs actually incurred while overseeing the cleanup of the above underground storage tank site, and the above Responsible Party or Parties shall make full payment of such costs within 30 days of receipt of a detailed invoice from the State Water Resources Control Board. CONT {OJEC IgE 468-3450 DATE: 209 . ignature Telephone Number Add: Reason: -- Delete: x _ Reason: Change: Reason: STANDARD FORM UST03(1/91)