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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WALNUT GROVE
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8960
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2900 - Site Mitigation Program
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PR0506456
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
6/22/2020 7:56:02 AM
Creation date
6/22/2020 7:47:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0506456
PE
2950
FACILITY_ID
FA0007437
FACILITY_NAME
M & K GAS STATION
STREET_NUMBER
8960
Direction
W
STREET_NAME
WALNUT GROVE
STREET_TYPE
RD
City
THORNTON
Zip
95686
APN
00115029
CURRENT_STATUS
02
SITE_LOCATION
8960 W WALNUT GROVE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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I� <br /> MMIT B <br /> The Chief Financial Officer or the owner or operator must sign, under penalty of perjury, a letter <br /> worded EXACTLY as follows or you may complete this letter by filling in the blanks with <br /> appropriate information_ <br />! LETTER FROM CHIEF FINANCIAL OFFICER <br /> SUNNYSIDE PRODUCE <br /> I am the Chief Financial Officer <br /> (Business name, business address,and correspondence address of owner or operator) <br /> 8960 W. Walnut Grove Road, Thornton, CA P.O. Box 700 Thornton, 1CA 9568( <br /> This letter is in support of.the use of the Underground Storage Tank Cleanup Fund to demonstrate <br />! financial responsibility for taking corrective action and/or compensating third parties for bodily <br /> injury and property damage caused by an unauthorized release of petroleum in the amount of at least <br /> $ 5000 . 00 per occurrence and $ 5 0 0 0. 0 0 annual aggregate coverage. <br /> (Dollar Amount) .(DolIar Amount) <br /> i' <br /> Underground storage tanks at the following facilities are assured by this letter: <br /> I� SUNNY SIDE PRODUCE 8960 W. Walnut Grove Raod, Thornton, 'ICA <br /> (Name and address of each facility for which financial responsibility is being demonstrated.) o <br /> 0 <br /> I <br /> 1. Amount of annual aggregate coverage being assured j <br /> t by this letter........................................ $ 5 ' 0 0 <br /> 000 . <br /> 2. Total tangible assets............................... ............. $ .30) ZG. <br /> i r <br /> l <br /> 3. Total Iiabilities........................ <br /> 4. Tangible net worth (subtract line 3 from line 2. ! <br /> -F <br /> Line 4 must be at least IO times line I)..................... <br /> j I hereby certify that the wording of this letter is identical to the wording specified in subsection �f <br /> 2808.1(d)(1), Chapter 18, Division 3, Title 23 of the California Code of Regulations. <br /> I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge <br /> s <br /> and-belief. <br /> Executed at Yl !��co n .. ..� �y] �' <br /> (Place of Execution) !! <br /> On 1�- <br /> i <br /> (Date) <br /> (Signature) <br /> M ryAnn Manser <br /> (Printed Name) Chief Financial Officer <br /> (Title) <br /> UST 01.Fit REVISED drys Page 29 I� <br /> i <br />
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