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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545512
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
3/11/2020 5:10:41 AM
Creation date
3/10/2020 1:37:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545512
PE
3526
FACILITY_ID
FA0003679
FACILITY_NAME
CALIFORNIA STOP*
STREET_NUMBER
2224
STREET_NAME
MANTHEY
STREET_TYPE
RD
City
STOCKTON
Zip
95206
APN
16313007
CURRENT_STATUS
02
SITE_LOCATION
2224 MANTHEY RD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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Dung Phan And Nhuan Le -2- <br /> • On page seven (7) of your claim application, Claimant must provide an "original signed" Verification <br /> and Signature Page including signatory's title as related to the claimant(see enclosed Verification and <br /> Signature page). Whose signature is on page 7? Include Claimant's Printed Name(which must be <br /> legible). <br /> • The Certification offinancial Responsibility form is being returned for clarification/revision. Under <br /> Section B, the Name of Tank Owner or Operator is listed as.Allied Insurance. This should be the <br /> name of Tank Owner or Operator. Should this have been claimant's name? Did/does Allied <br /> Insurance own/operate USTs? Also, whose signature is on this document in Section E as the Tank <br /> Owner or Operator? If this form is revised send original to San Joaquin County EHD and a copy <br /> to the Fund. <br /> • The Letter From Chief Financial Officer is for California Stop. Provide documentation to show <br /> ownership of California Stop (dba?) or change to the name of the UST Owner or Operator. Also, <br /> whose signature is on this document? If this form is revised send original to San Joaquin County <br /> EHD and a copy to the Fund. <br /> • The UST Unauthorized Release (LEAK)/Contamination Site Report indicates the Operator as Tri <br /> Phan. This name is not listed on page three (3) of your claim application. Please clarify and revise <br /> only ppropriate pages of the claim application if necessary. <br /> • Submit a copy of the first permit issued to you to own or operate the UST after you acquired site(on <br /> 12/24/99) from the local regulatory agency (Air Pollution permits are not acceptable). <br /> • Claimants who acquire sites after January 1, 1990,must complete the enclosed Claimant Certification <br /> of Compliance with Fund Regulations Section 281 l(a)(1)-(2) and Health & Safety Code, Section <br /> 25299.54, subdivision (h). <br /> AND <br /> • If there were any USTs located at this site before January 1, 1990,provide a copy of the permit to <br /> own or operate the UST from the local implementing agency dated between January 1, 1984 and <br /> January 1, 1990 (pursuant to Chapter 6.7 of the Health and Safety Code). Please clarify. <br /> • Copy of San Joaquin County's letter dated March 7,2002 (referenced in their letter dated February 9, <br /> 2005). <br /> • Claimant is required to provide documentation that all current and prior UST fees due on or after <br /> January 1, 1991 imposed by Section 25299.41 of the Health and Safety Code have been paid. If any <br /> of the USTs owned or operated had product placed in them on or after January 1, 1991, attach the <br /> most recent copy of the UST Fee Return Forn-i filed with the State Board of Equalization (BOE)with <br /> proof of payment(copy of canceled check). <br /> Priority Class "B" small business is for those businesses that are independently owned and operated,not <br /> dominant in its field of operation and employs 100 or less employees, including all affiliates, and <br /> averages annual gross receipts of$10 million dollars or less over the previous three years. If a business is <br /> a manufacturer, there is no revenue test. However, the manufacturer must also employ 100 or less <br /> employees including affiliates. <br /> California En vironmental Protection Agency <br /> fir}Recycled Paper <br />
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