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V <br /> State Water Resources Control Board <br /> Underground Storage Tank Cleanup Fund <br /> PERMIT WAIVER REQUEST FORM <br /> CLAIMNO.: 12886 <br /> CLAIMANT NAME: FRONTIER TRANSPORTATION, INC. <br /> SITE ADDRESS : 425 LARCH, TRACY <br /> Claimants who were subject to the permit requirement but failed to comply by January 1 , 1990, can request the State Water Resources <br /> Control Board (SWRCB) to waive the requirement as a condition for eligibility if the four requirements listed below have been met. <br /> Where the SWRCB grants the waiver, the level of required deductible is twice the amount otherwise required. In this case, the above- <br /> named claimant will be responsible for the fust $ 10,000 of eligible corrective action costs before Fund coverage begins. <br /> I, FRONTIER TRANSPORTATION, INC., HEREBY REQUEST THE SWRCB TO GRANT A PERMIT WAIVER, TO QUALIFY <br /> FOR THIS WAIVER, I AM SUBMITTING DOCUMENTATION SHOWING THAT THE FOLLOWING FOUR PERMIT <br /> WAIVER REQUIREMENTS HAVE BEEN MET: <br /> 1 . The claimant was unaware of the permit requirement prior to January 1 , 1990, and did not intend to avoid the permit <br /> requirement or the associated fees. <br /> DOCUMENTATION: Provide a brief history of the UST(s) and an explanation as to why the UST(s) were not <br /> permitted by January 1, 1990. Explain when and how you became aware of the law requiring a permit to own or <br /> operate the UST(s). (Attach additional sheets as necessary. <br /> 2. Prior to filing a claim, the claimant has complied with the financial responsibility requirements of Section 25299.31 of the <br /> Health & Safety Code (H&SC). <br /> DOCUMENTATION: Attach a copy of the Certificate of Financial Responsibility that is on file with the local <br /> regulatory agency. <br /> 3 . The claimant has obtained and paid for all currently required permits. <br /> DOCUMENTATION: If you owned or operated the UST(s) at the time of submitting the claim application, attach <br /> a copy of the permit to own or operate the UST(s) or a copy of the application to the local agency for a permit <br /> indicating that you are diligently pursuing the acquisition of a permit. If the UST(s) were removed prior to <br /> submitting your claim application, attach evidence that the UST(s) were removed, and the local regulatory agency <br /> notified, and a copy of the removal permit. <br /> 4. The claimant has paid all current UST fees imposed by Section 25299.41 of the H&SC, and all prior fees due on and after <br /> January 1 , 1991 . <br /> DOCUMENTATION: If any of the USTs owned or operated had product placed in them on or after January 1 , <br /> 1991, attach the most recent copy of the UST Fee Return Form filed with the State Board of Equalization with <br /> proof of payment. <br /> CLAIMANT SIGNATURE: <br /> PRINT SIGNATURE DATE: <br /> Note: Mail completed "Permit Waiver Request" and documentation to the address on the cover letter. <br /> Our mission is to preserve and enhance the quality of California 's water resources, and <br /> �� Recycled Paper ensure their proper allocation and efficient use for the henefri of present and future generations. <br />