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CALIFORNIA 'INDERGROUND STORAGE TANK CL`- NUP FUND <br /> v COST PRE-APPROVAL REQUEST N--10 <br /> (Complete form, enclose required Items, sign, date & return) <br /> TO: Jaded IJiGiorgio Fax: (916) 227-4530 <br /> UST Cleanup Fund, 2014 T Street, Sacra e-nco, CA 95814 <br /> I. CLAIM INFORMATION <br /> A. CLAIM NO. 12586 B. CLAIMANT Tuleburg Warehouse <br /> C. CLAIM STATUS (complete appropriate section) <br /> 1) LOC ISSUED FOR �n,nnn <br /> ii) ON PRIORITY LIST? ❑YES ❑ NO IF YES, PRIORITY CLASS ❑A ❑ B ❑ C ❑ n <br /> iii) NOT YET APPLIED TO THE FUND, EXPECTED APPLICATION DATE: <br /> D. CONTACT PERSON: William J. Hunter PHONE:(916) 972-7941 _ <br /> ADDRESS: FAX: (916) 972-1683 <br /> II. TYPE OF REQUEST {check aooroariate boxes) <br /> El PRE-APPROVAL $33,000 AMOUNT REQUESTED <br /> El 3-BID REVIEW PREFERRED BID (if applicable) <br /> THE FOLLOWING DOCUMENTS ARE REQUIRED FOR THE SPECIFIED REQUEST. ALL <br /> DOCUMENTS REQUESTED MUST BE SUBMITTED 01�__THE REQUEST(S) WILL BIrUIF , <br /> A. REQUEST FOR PRE-APPROV6LOF RRQPO5_.D COSTS - The following items are required before <br /> and determination will be made by Fund staff. <br /> 1 . -1 A complete signed copy of the proposed Investigation Workplan or Corrective Action Plan (CAP) tat <br /> defined and required by Article 1 1, Chapter 16, California Underground Storage TankRegula[iclost. <br /> Corrective Action Plans must include the required feasibility study and chosen cost effective alternatrvc-. <br /> 2. X A signed copy of the oversight agency approval letter for the Workplan/CAP. <br /> 3. _LA complete copy of the Request For Bids, including all attachnients. A list of all firms requested "+i_� <br /> must be included. <br /> 4. ._JComplete copies of all bids and other correspondence submitted in response to the Request For bid?, <br /> 5. XA time schedule, if not part of bid documents,—anticipated for project initiation and duration. <br /> 6. XA detailed project budget, which includes breakdowns of staff/task/hour with associated estimate:! totals. <br /> B. THR D R V! W/ V IATI0 /Dc''r TA ION . Fund staff will assist any claimant requesting .in <br /> evaluation of bids upon request. 'fh: following lnfon-n3don must be submitted - I, 2, 3 AND 4 as described in <br /> Item A above. <br /> Ill. CERTIFICATION. <br /> l ce.tily andel penalty of pe fury that all tnlntaatiun suhnullerd with this tequest;s complete and accurate and in accordance :s:;h.alp <br /> applicable Claws a 7'ula rbns. <br /> July 13 1998 <br /> Signature — D.IEe -- . .. <br />