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X, CERTIFICATIONS AND AGREEMENTS (WE)HERESY CERTIFY THAT: 1 I(We)am(are)the owner or operator of an Underground Storage Tank from which there has been an unauthorised release of petroleum for which a claim apektsl the Fund is permissible under Chapter a 75 of the California Health and Safety Code 2 Chumant(s)is(ane)entitled to submit this claim application for renrnbursementfrom the Fund 3 All costs claimed herein were incurred after January 1 1988 are reasonable and necessary and aro eligible for reimbursement from the Fund 4 4 Claimart(s)obtained any permits required of the ekumvd(s)under Chapter 6 7 of the California Health and Sedety Code when such permits were required or chumant(s)had filed substantially complete applications for any permits required of dmmant(s)on January 1 1900,by that date,or if claimant cannot to certify,clalmant hes submitted documentation of the facts and circumstances which aro relied upon to demonstrate that obtaining any required pemnq was beyond the reasonable control of dsimant(s)or that it would be unreasonable or inequitable to require the ekknert(s)to have filed an application ler such a permit Janus 1 1990 Pe by January , 5 Claimants)are lin compliance with any applicable financial responsibility requtremarts contained in Article 3,Chapter 18,Division 3 TWO 23,California Code of Regulations(Petroleum Underground Storage Tank Cleanup Fund Regulations) 6 As to all costs claimed which were incurred before the effective date of Cleanup Fund regulations(December 2,1991),any coact tho action taken by claimant(s)was A In accordance with applicable provisions of Chapter 6 7 of the California Health and Safety Code and Subchapter IX of Chapter 82 of Title 42 of the United States Code and the Federal Regulatmi;adopted pursuant thereto and 0 8 Consistent with any oral or written orders directives,approvals or notification of cleanup responsibility issued by state,local or federal agencies having authority or responsibility over underground storage tanks and consistent with any applicable waste discharge requirements shire policies for water quality control and water quality control plans 7 As to all costs claimed which were Incurred on or after the effective date of Cleanup Fund Regulations(December 2,1901) a A Clairnant(s) It subject to the permit requirements of Chapter 6 7 of the California Health and Safety Codi (1)arse in compliance with any applicable corrective action requirements established pursuant to Article 4 of Chapter 6 75 of the Calrfomia Health and Safety Code Including any Implementing regulations contained in Article 11,Chapter 16 Division 3 Title 23,California Code of Regulations and(2)has(have)notified the approppate local agency or Caldomia Regional Water Quality Control Board of the release which is the subject of this dam and has(have)been required or pamutwd p by such agency or agencies to undertake the corrective action for which reimbursement is sougK and claimant(s) , is(are)in compliance wrth the requirements or any orders or directives issued by such agencies B Claimant(s),M not subject to the permit requirements of Chapter 6 7 of the Cald0 mia Health and Safety Code,meet the conditions specified in Paragraph a above 8 Claimant(&)did not know of the unauthorized release which is the subject of this clam prior to January 1 1988 or if such release was known prior to that date, any required corrective action related to that release was Initiated on or before June 30 1988 9 Chumant(s),If owner(&)of the site Involved does(do)not know of any fads which would preclude any party from whom the site was acquired from filing a dalrn for reimbursement against the Fund o I � I (WE)JOINTLY AND SEVERALLY AGREE THAT 1 All records pertaining to the ciaims included in this Clam Application will be retained for a period of at least three years from the date of final payment on the Iast phase of work reimbursed from the Fund This three year period of retention shall be extended until completion of any audit in progress at the conclusion of the three year retention pend All such records shall be made available to the State Hoard or any designated representative thereof upon request 2 All reimbursements made pursuant to this Claim Application are subject to audit by the State Board or any representative thereof Ctwmant(s)will reimburse the State for any costs finally tksallowed pursuant to such an audit II PAGE 7