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REPAIR UNDERGROUND STORAGE TANK <br /> APPLICATION <br /> Part 2 <br /> I. List each underground storage tank ("UST") owned or operated by the business applying for a <br /> loan from the California Commerce Department ("Applicant"). The list shall include the <br /> address of eat UST, the number of USTs at each location, and indicate which USTs will be <br /> included in the project using loan funds ("Project Tanks"). Also provide a copy of any <br /> correspondence between the Applicant and a public agency concerning any UST owned or operated <br /> by the Applicant. <br /> 2. For each UST, include a copy of the current permit. Evidence of a current permit shall <br /> consist of one of the following: <br /> a) Copy of a current permit issued by the county or city agency charged with <br /> responsibility for USTs ("Local Agency"); or <br /> b) Both of the following: <br /> 1) A completed State Water Resources Control Board Form A & B. signed by an <br /> authorized representative of the Local Agency; and <br /> 2) Evidence that the permit fee has been paid for each USF for the current year, <br /> consisting of a cancelled check or a receipt from the Local Agency. <br /> 3. A description of any unauthorized releases from a UST owned or operated by the Applicant, <br /> including copies of correspondence with the Local Agency, and reports made to insurers. <br /> a. Information regarding the project for which funding is being requested ("Project"), including <br /> a description of the reasons why: <br /> a) The Project Tanks either currently are not, or in the future will not, be in compliance <br /> with federal , state or local standards: <br /> b) The Project will result in Project Tanks which are in compliance with federal, state or <br /> local standards. <br /> 5_ Describe the Project in detail, including: <br /> a) A list of the Project components, with the cost and time line for the completion of <br /> each component; <br /> b) The name and applicable experience of the individual or firm preparing the cost <br /> estimates, and copies of any supporting invoices, estimates or contracts; <br /> C) A list of any permits necessary to carry out the Project. <br /> 6. A Project can consist of the upgrade, repair or removal of a UST used to store petroleum. The <br /> Project can also include corrective action. Corrective action can include any action taken to <br /> correct an unauthorized release from a UST used to store petroleum, including: evaluation and <br /> investigation of an unauthorized release, initial corrective action measures, clean-up of the <br /> release. any actions necessary to investigate and remedy any residual effects remaining after <br /> the initial corrective action and post clean-up monitoring. <br /> If the Project includes corrective action measures, provide the following information: <br /> a) A description, budget and time line for each segment or activity comprising the <br /> corrective action, and the identified source of funding for each segment or activity; <br /> b) A copy of any corrective action plan filed with a public agency. <br /> 7. Provide a copy of all monitoring reports conducted on any Project Tank during the last three <br /> years. <br /> _ ,DOS/kn <br />