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PV1 <br /> CGRS <br /> SOLUTIONS DELIVERED <br /> GENERAL CONTRACTOR STATEMENT <br /> Effective 05/26/1S,the State Water Resources Control Board requires that the signed general <br /> contractor's statement be received from all general contractors prior to formal notification of final <br /> ELD testing (NO EXCEPTIONS). <br /> By signing below,the general contractor acknowledges that: <br /> "No further ground penetrating work,including beautification requirements,atop or immediately <br /> adjacent to,the UST system are needed or will be performed after ELD testing is performed." <br /> General Contractor Information <br /> Company Name/CA Contractor License#: Town&Country Contractors <br /> Contact: Sean Murphy <br /> Address: 3181 Luyung Dr.#A, Rancho Cordova, CA 95742 <br /> iTelephone/Email: 916-636-9500/sean@tccontractors.com <br /> Site Information <br /> Site Name: Arco AM/PM <br /> Address: 4607 S.Airport Way,Stockton,CA 95206 <br /> Telephone: unknown <br /> County: Stockton <br /> CUPA Email: ust@sjgov.org <br /> Testing Company Information <br /> Name: CGIRS, Inc. <br /> Technician Assigned/License#: Adam Montejano/#1775 <br /> Signature <br /> General Contractor's Signature: ...... <br /> Name(print): Mark Farmer <br /> Title: PM Date of Signature: 9/24/2025 <br /> 5444 Dry Creek Rd, Sacramento,CA 95838 T 916-991-1100 F 916-991-1177 www.cgts.com <br />