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Kasey Foley <br /> San Joaquin County <br /> Environmental Health Department <br /> Certified Unified Program Agency(CUPA) -2- November 19, 2012 <br /> 6. Three (3) sets of the Manufacturers'Affirmative Statement of Compatibility <br /> 7. Three (3) sets of Tank Installation plans, (2 wet signed) prepared by Barghausen Consulting <br /> Engineers, Inc., dated October 29, 2012 <br /> 8. One (1) check issued by Barghausen Consulting Engineers, Inc., in the amount of$1,140, <br /> for the installation of the Fuel Additive tank and equipment, made payable to San Joaquin <br /> County Environmental Health Department <br /> 9. One (1)check issued by Barghausen Consulting Engineers, Inc., in the amount of$375, for <br /> the retrofitting of the existing gasoline storage tanks to accommodate the Fuel Additive <br /> Tank, made payable to the San Joaquin County Environmental Health Department <br /> 10. Three (3) sets of the Application for Underground Storage Tank Installation Permit <br /> Package: <br /> a. Application for Underground Storage Tank Installation Permit <br /> b. Completed UPCF UST Facility Form (A) <br /> c. Completed UPCF UST Tank Form (B), for the new Fuel Additive UST—Tank 4 <br /> d. Monitoring Plan and Site Plot Plan—Tank 4 <br /> e. Updated Response Plan <br /> f. San Joaquin County Environmental Health Department Service Request Form <br /> (Service Code: 031 / PE: 2303) <br /> g. Fee Sheet ($1,140 for Installation) <br /> 11. Three (3) sets of the Application for Underground Storage Tank Retrofit or Piping Repair <br /> Permit Package: <br /> a. Application for Underground Storage Tank Retrofit or Piping Repair Permit <br /> b. Authorization to Release Information-Not Applicable, soil sampling will not be <br /> conducted <br /> c. Completed UPCF UST Tank Form (B)for existing USTs—Tanks 1, 2 and 3 <br /> d. Updated Monitoring Plan and Site Plot Plan—Tanks 1,2, and 3 <br /> e. San Joaquin County Environmental Health Department Service Request Form <br /> (Service Code: 198/PE 2308) <br /> f. Fee Sheet($375.00 for Retrofit) <br /> It is our understanding that the items referenced above comprise a complete package for the installation <br /> of the Fuel Additive equipment and the retrofitting of the existing gasoline storage tanks. If you need <br />