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BAGLIETTO SEEDS Fax:209-465-6377 Aug 26 '97 9:04 P.03/03 UNUKRGROU"STORAGE TANK CLEAMP FUNDV16GRAM pf.RM T WAIVER ItEQUW CLAIMANT: 'IUL.EBURG WAREHOUSE CLAIM NO.: 125$6 SITE ADDRESS. 9200 HWY 9914,STOCKTON Cln<izuants who were subject to the permit requirement but failed to comply by January 1, 1990,can request die State Board to naive the requimment as a condition for eligibility. Where tate Sate Board gr�the waiver,the financial level of mWonsibr7ity(deductible)is twice the amount uthetwisc regaifed. [n this case,the claimact will be responsible for the first S 10,000 of eligible corrective action casts before Fund coverage begivas. 1,TULEBURG WAEtEHOUSE,hereby request the State ROmrd to grant a posmit waiver. TO qualify for the waiver, I am submitting the following documentation: I. The claimant was unaware of the pernsit"quiramt prior to Jamary 1,1990,and there was-no intent to avoid the permit requirement or the associated£cos. Docetsmentstiata:Ort the lanes below,pr"e a brief history of the underground st*mge tanks(USTO and an explanation as to the reason why the USTs were pot permitted by January 1, 1994. Explain when and Stow you became aware of the law requiring a permit tti own or opaute the USTs, 2. The claimant has complied with the financial responsibility requirements of section 25299.31 of the Health& Safety Code(14&SC). Docun estation:Attach a copy of the Certificate of Financial Responsibility that is on file with the[tical regulatory agency. 3. The claimant has obtained and paid for all currently required pertmita. DocumentotioA:if ycu owned or Opera the USTs at the time of submitting the eWhn application,smttach a copy of the permit to own or operate the[►STs or a copy of the applicadiov indicating you are diligently pursuing tlme aoquisitimm yf the permit isnated by the local tegulatury agency. if the USTs were removed prior to submittal of the claire appliegfig m,attacw evidence that the USTs were removed,the local regulatory agency notified,mmol it copy of the mquired removal permit. 4. The claimant has paid all UST fees imposed by Section 25299.4[ of tate H&SC due on and after January 1, 1991. Documentation:If any of the USTs owned or operated had WOW placed in them on or after January 1, 1991,attach the most rcaent copy of the UST Fee Return FOM pled with the Board of Equalization with proof of payment. (For further biforrnatlan on this form,contttd the Nuel Taxes Division at(916)322-9669.) print Claimant Name Sign Claimant Name -NQie:Mail completed"Permit Waiver Request"and documentatiotm to the address on the cover letter. /�r or mamian a tvprerew mid eliinnee she q.ality Vca4fa,,,ia,r,mur m-yourrer,Qnd 7? .+� RFcyGfed Paper eruaere thrlr pepper 0110 bn WW X9eknr umf,the bewflt of prem and fi4h"generalims.