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St Johns Protestant Episcopal Church Of Stockton Ca-2- 2. A Reimbursement Request Form. Two copies of this form have been enclosed for your use in this packet. Instructions for filling out the Reimbursement Request form can be found on the back of the form. Instructions for completing the entire Reimbursement Request package can be found at: http://www.wat boards.ca. ov/water issues/ ro rams/ustcf/docs/reimbursement i nstructions/reimbursementreguestinstructions.pdf 3. A Reimbursement Request Spreadsheet. This form is used to organize and track corrective action costs incurred. A template for your use can be found at: http://wv,fw.waterboards.ca.gov/water issues/ ro rams/ustcf/docs/reimbursement i nstructions/rrspread sheet.xis. After completion, this spreadsheet must be printed and submitted with your reimbursement request. Additionally, you must submit the completed spreadsheet electronically to the Fund. Instructions for this, and general spreadsheet use, can be found at: http://www.waterboards.ca.gov/water issues/ ro rams/ustcf/docs/reimbursement i nstructions/reimbursementreguestforms.pdf. THIS IS IMPORTANT TO YOU PLEASE NOTE: Signature(s) on the application will be the signatures) required for all future Fund documents. You have 90 calendar days from the date of this letter to submit your first reimbursement request for incurred corrective action costs. We continuously review the status of all active claims. You must continue to remain in compliance and submit either a reimbursement request every 6 months, or a status report of your site. Failure to do so will result in the Fund taking steps to withdraw your LOC. If you have any questions regarding the enclosed documents, please contact Ginny Lagomarsino at (916) 341-5722. Sincerely, Allan Patton, Acting Fund Manager Underground Storage Tank Cleanup Fund Enclosures California EnvironmentaiProtecdon Agency Z,'j%ecyded Paper