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ivvi k:: Ell?'ective July .l, 1995, ualimornin bmall businesses and t-amornm»usrluessra wxtu avv <br /> employees or cess musonstrate at least$5,000, exclusive o UST Cleanup Feud, <br /> businesses with over 5 Otployees must demonstrate at least 00. (Chap.6.75 H&SC, <br /> Sect.25299.32) <br /> The Chief Financial Officer or the owner or operator must sign,under penalty of pedury, a letter worded <br /> EXACTLY as follows or you may complete this letter by filling in the blanks with appropriate infortnationi: <br /> LETTER FROM CHIEF FINANCIAL OFFICER <br /> I am the Chief Financial Officer for Canepa's Car Wash _ w <br /> (Business nanx,business address,and correspondence.address of owner or oprrator) <br /> ulttgr Street. Stockton,California 95204 <br /> This letter is in supppil of the use of the Underground Storage Tank Cleanup Fund to demonstrate financial <br /> responsibility for taking corrective action and/or compensating third parties for bodily <br /> injury and property damage caused by an unauthorized release of petroleum in the amount of at least <br /> $ 51000 per occurrence and. 5,000 annual aggregate coverage. <br /> (Dollar Amotint) (Dollar Amount) <br /> Underground storage tanks at the following facilities are asswed by this letter: <br /> Canoo's Car Wash,6230 Pacific Ave.. Stockton.CA 95207 T'` <br /> (Name and address of each facility;fox which financial responsibility is being demonstrated.) <br /> Canepa's Car Wash.248 E,Park Street, Stockton, C.A. 95202 <br /> I. Amount of annual aggregate coverage being assured <br /> bythis letter......................................................................... $ x,090 <br /> 2. Total tangible assets................................................... .......... $ <br /> 3. Total liabilities....................................................................... $ <br /> 4. Tangible net worth(subtract line 3 from line 2. <br /> Line 4 must be at least 10 times line 1).................................. $ <br /> I hereby certify that the wording of this letter is identical to the wording specified in subsection 2808.1(d)(1), <br /> Chapter IS,Division 3,Title 23 of the California Code of Regulations. <br /> I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge and belief. <br /> Executed at .� . ��- <br /> (place o,Execution) <br /> On- 10 j w <br /> (Date) <br /> (Signatwc) _ <br /> (Printtd Name) _ � <br /> (Title) <br />