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. Claimant -3- ! <br /> Date i <br /> Claim No. <br /> I <br /> If you believe you meet the requirements under AB 1437, you must complete the <br /> enclosed permit waiver form and submit a new claim application. Any previous <br /> applicable backup documentation submitted with this claim (number 19104), will be <br /> incorporated into the new claim application; therefore duplication is not necessary, <br /> except for forms that require a current date/signature (i.e., updated financial <br /> responsibility documents). <br /> Appeal Process <br /> This represents a Staff Decision. If you disagree with this decision, you may appeal to <br /> the Fund Manager pursuant to Section 2814 of the Petroleum Underground Storage <br /> Tank Cleanup Fund Regulations. J <br /> If you would like review of the decision by the Fund Manager, please submit your i <br /> request along with any additional documentation to: <br /> Ronald M. Duff, Fund Manager, Claim #019091 <br /> Underground Storage Tank Cleanup Fund <br /> State Water Resources Control Board <br /> Division of Financial Assistance <br /> P.O. Box 944212 <br /> Sacramento, CA 94244-2120 <br /> A request to the Fund 'Manager must include, at a minimum: (1) a statement describing <br /> how the claimant is damaged by the prior Staff Decision; (2) a description of the remedy <br /> or outcome desired; and (3) an explanation of why the claimant believes the Staff <br /> Decision is erroneous, inappropriate or improper. <br /> .i <br /> If you do not request a review by the Fund Manager within thirty (30) calendar days <br /> from the date of this letter, the Staff Decision will then become final and conclusive. <br /> If you have any questions, please call me at (916) 341-7361. <br /> Sincerely,, <br /> I! <br /> I <br /> Lisa Labrado <br /> Claims Review Analyst h <br /> Claims Review Unit !` <br /> Underground Storage Tank Cleanup Fund <br /> Enclosures <br /> California Envlronmental Protection Agency <br /> ��Recycled Paper <br />