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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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12 (STATE ROUTE 12)
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13889
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3500 - Local Oversight Program
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PR0545719
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
11/19/2024 3:47:36 PM
Creation date
6/3/2020 11:22:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545719
PE
3528
FACILITY_ID
FA0005335
FACILITY_NAME
CHARLES JACOBS
STREET_NUMBER
13889
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
13889 W HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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State Water Resources Control Board <br /> Division of Financial Assistance .o <br /> 10011 Street•Sacramento,Califomia 95814 <br /> P.O.Box 944212•Sacramento,California•94244-2120 Arnold Schwarzenegger <br /> Alan C.Lloyd,Ph.D. (916)341-5761 • FAX(916)341-5806 • www.swrcb.ca.gov/cwpe/ustcf Governor <br /> Agency Secretary ILrr`'�-. <br /> ChazleNJac bs 005 JAN 2 4 7005 <br /> 13889 Hwy 12 W ENVIRON%4ENT HEALTH <br /> Lodi, CA 95242 PERMIT/SERVICES <br /> UNDERGROUND STORAGE TANK CLEANUP FUND (FUND), CLAIM NO. 018115, FOR <br /> SITE ADDRESS: 13889 HWY 12 W,LODI <br /> The State Water Resources Control Board (State Board)is able to issue, pursuant to applicable <br /> regulations, the enclosed Letter of Commitment (LOC) in an amount not to exceed$20,000. <br /> This LOC is based upon our review of the corrective action costs you reported to have incurred <br /> to date. The LOC may be modified by the State Board. <br /> It is very important that you read the terms and conditions listed in the enclosed LOC. Claims <br /> filed with the Underground Storage Tank Cleanup Fund far exceed the funding available and it is <br /> very important that you make use of the funding that has been committed to your cleanup in a <br /> timely manner. <br /> You are reminded that you must comply with all regulatory agency time schedules and <br /> requirements and you must obtain three bids for any required corrective action. Only corrective <br /> action costs required by the regulatory agency to protect human health, safety and the <br /> environment can be claimed for reimbursement. If you have any questions about obtaining <br /> preapproval of your costs or the three bid requirement,please call Mark Owens, our Technical <br /> Reviewer assigned to claims in your Region, at(916) 341-5796. Failure to obtain preapproval of <br /> your fixture costs may result in the costs not being reimbursed. <br /> The following documents needed to submit your reimbursement request are enclosed: <br /> Reimbursement Request Instructions and Information packages. Retain these packages for <br /> future reimbursement requests. These instructions must be followed when seeking <br /> reimbursement for corrective action costs incurred after January 1, 1988. <br /> "Reimbursement Request" forms which you must use to request reimbursement of costs <br /> incurred. <br /> "Spreadsheet" forms which you must use in conjunction with your reimbursement request. <br /> 1. THIS IS IMPORTANT TO YOU, PLEASE NOTE: <br /> Signature(s) on the application will be the signature(s) required for all future Fund <br /> documents. <br /> California Environments/Protection Agency <br /> Pia Recyc%dPaper <br />
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