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<br /> sace afcabramw
<br /> saro covet Rcsowcer Coatran soars pwsaaaur �t NOTE: Effective July 1,1995,Ca0fornia Small Businessm and Cnli[ornis Businesses with 500
<br /> Dnislon ofPmanomi Auaaaa s yy5 employees or lessuarst demonstrate at least$5,000,exclusive oftke UST Cleaaop FSmd,
<br /> S P-0.aox9442nz businesses wlNI over 500 em 1 yeas must demonstrate at least$10,000. Chap.6.75 R&.SC,
<br /> sa«emm,a.ca s42.1110 Sect 25299.32) P o
<br /> CERTIFICATION OF FINANCIAL RESPONSIBILITY The Chief Financial Officer or the owner or operator must sign,under penalty ofperjury,a letter worded
<br /> o caouxp sro o EXACTLY as follows oryou may complete this]eater by filling in the blanks with appropriate information:
<br /> ❑l500. o,,;,,e.,,„nb.,,,a.sx„cc mri;o.xcmw,a [Ig LETTER FROM CHIEF FINANCIAL OFFICER
<br /> sao,000 dnuare p«n�amenne a®Imufinn amlaa sM el aggregme
<br /> mOAND I am the Chief Financial OtHcer,foe Short Stop Food Mert
<br /> I lbnd.II-p«occuee L]2 mining dollars mmaal aggregate
<br /> (ee.ivmmmq eewwuwvw�a��ea<.�ware®erom�e.op",.n,)
<br /> «ninoumai.m<en,ii.m<wiume oeaamw�.c"xor 20 W Turner Rd A,Lodi CA.95240
<br /> 6•�akhw'nd fiingh Sandh eyed tions,Tiaa23,pividan l,CNpiv lB,Aa o�I.Sx�1 r28or.
<br /> The mecknine aced to demonstrate financial resonsibin as re aired b sect ion2807—hall.— This letter is in support ofthe use fthe Underground Storage Tank Cleanup Fund to demonstrate finanotal
<br /> C.mdwmwa xamp dedaross FI tse L®hm cpyarage cuvayase coaeat 0F«tr responsibility fur takingconective action mad/or compensating third parties for bodily
<br /> M umi'er. Amar_t P.mod} AW ,,:ed rgmpmsanof', injury and properly damage caused by an ucauthothed release of petroleum in the Mount ofat least
<br /> State UST Fund state UST Cleanup Fund N/Afor See5,00nper State UST $ 5000.00 per occurrence and$500000 annual aggregate coverage.
<br /> P.0.9ox 944212D UST Occurrence Cleaning YES YES (oonaraeo�m) (odiarnnwm)
<br /> Sar—re.,CA 942442t2o Clearing And Fund
<br /> g Annual Underground storage tanks at the following facilities are assured by this letter:
<br /> Fund Aggregate Continuous
<br /> Chief Financial Short Stop Food Mart N/A For $5000 Per Short Stop Food Mart 20 W Turner Rd A Lodi CA 95240
<br /> Officer Letter 20 W Turner Rd Is Occurrence Annual YES YES (Nomeenaaddmesofcech a<ilitys,—hiohfwwcielrespoosibiiiry is bcingdemommeaJ
<br /> Lodi CA.95240 Mechanism and Annual
<br /> Aggregate
<br /> 1. Amount of arcual aggregate coverage being assured
<br /> bythis letter......................................................................... $ 5000.00
<br /> 2. Total tangible assets.............................................................. $�
<br /> xa<. ierm+a,<a:me a<smaruna�anrpmorrowaeaemav ,orrt«cwi bdiry.row'vaufi„nvtlsiM,ivsim,ofn,i<catiGmionelm 3. Total li.bilitl..........................................................I............. $
<br /> min«imr „ <w„runeow.a>xmima.mm<omcirem<w,uan<oaamon<rr
<br /> < naw wiwnw,wm<ecca.
<br /> Short Stop Food Marl ”`""°`^
<br /> D. ++„•- P 4. Tangible net worth(s 1 10 ti line 3 from line 2.
<br /> 20 W Tomer Rd A,Lodi CA.95240
<br /> Line 4 mull be at least IO times line I).................................. $
<br /> „a ... I hereby certify that the wording of this letter is identical to the wording specified in subsection 2808.1(d)(1),
<br /> Chapter 18,Division 3,Title 23 ofthe California Code of Regulations.
<br /> I declare under penalty ofpmjtuy that the foregoing is true and correct to the best of my knowledge ad belief.
<br /> n„w. ... Executed at Lodi CA.
<br /> (pace afemaaa)
<br /> on__ 5 I I 1p 122
<br /> E.s.......4..._ _ w...aom+.ao....m.e
<br /> 5�llopl2 Lakhwinder Singh Saadhu owNeRIOPeRATOR Lakhwinder Singh Sandhu
<br /> (Printed Nmn<)
<br /> Owner
<br /> Cly st each U
<br /> Submit ori¢ioal to local UST regulatory agency.Keepaco N facility, csroam,.„.d(ns
<br /> ST
<br /> UN-0J9-32 xmm.uvleaea.o,p
<br /> Rm,OAM6
<br />
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