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Home My WebLink About1701 STINE RD (4) IIIIIIIIVIIIIIIIIII 43 fE State of California For State Use Only State of Water Resources Control Board Division of Clean Water Programs P.O.Box 944212 Sacramento,CA 94244.2120 (Instructions on reverse side) CERTIFICATION OF FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEUM A. I am required to demonstrate Financial Responsibility in the Required amounts as specified in Section 2807,Chapter 18,Div.3,little 23, CCR: o 0 500,000 dollars per occurrence I million dollars annual aggregate or AND 7 or 1 million dollars per occurrence 2 million dollars armual aggregate B. NNN CA AUTO SVC LLC hereby certlfles that It is in compliance with the requirements of Section 2807, ((tame of Tank Owner or Operator) Article 3, Chapter 18, Division 3, Title 23, California Code of Regulatbns. The mechanisms used to demonstrate financial responsibility as required by Section 2807 are as follows: C'. Mechanism Mechanism Coverage Coverage Corrective Third Party Type, Nam.e:and Address of Issuer Number.. Amount Period Action Corn State UST Fund State UST Cleanup Fund N/A for UST $995,000 per State UST YES YES P.O.Box 944212 Cleanup Fund Occurrence and Fund Sacramento,CA Annual Continuous 94244-2120 Aggregate Chief Financial NNN CA AUTO SVC LLC N/A for this $10;000 per 'Annual YES YES Officei Letter 450 S. Orange Avenue mechanism Occurrence and Suite 900 Annual Orlando,FL 32801 Aggregate Note: If you are using the State Fund as any part of your demonstration of financial responslblRy, your executbn and submission of this certfkation also ce►t<fies that you are In compliance with a9 conditions for participation in the Fund. D. Facility Name Facility Address Sparkling Image Car Wash/Pennzoil Lube Center 1701 Stine Road,Bakersfield,CA 93309 Facility Name Facility Address Mission Car Wash 1601 San Fernando Road,San Fernando,CA 91340 Facility Name Facility Address E. Signature of Tank Owner or Operator Date Name and Title of Tank Owner or Operator 8r: �L r�/ "Fx�z.yr CFo Signture of Witness or Notary Date Name of Witness or Notary ' CFR(Revised 04/95) FILE: Original-Local Agency Copies-Facility/Site(s) 111111I3 44 State of California For State Use Only State of Water Resources Control Board Division of Clean Water Programs a P.O.Box 944212 I Sacramerrto,CA 94244-2120 +I (instructions on reverse side) CERTIFICATION OF FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEUM A. Ian required to demonstrate Financial Responsibility in the Required amounts as specified in Section 2807,Chapter 18,Div.3,Tide 23, CCR ❑ 500,000 dollars per occurrence t million dollars annual aggregate or AND or 1 million dollars per occurrence 2 million dollars annual aggregate B. NNN CA AUTO SVC LLC hereby certtfles that It is M compliance wth the requbements ofSectlon 2807, (Name of Tank Owner or Openrtoq Article 3, Chapter 18,Divlslon 3, T1tle 23, California Code of Regrr/atbns. The mechanisms used to demonstrate Anancial responsi0flAy as required by Section 2807 are as follows: C. Mechanism Mechanism Coverage Coverage Corrective Thlyd Parry 12e Name and Address of Issuer Number Amount Period Action Cam State UST Fund State UST Cleanup Fund N/A for UST $993,000 per State UST YES YES P.O.Box 944212 Cleanup Fund Occurrence and Fund Sacramento,CA Annual Continuous 94244-2120 Aggregate Chief Financial NNN CA AUTO SVC LLC N/A for this $10,000 per Annual YES YES Officer Letter 450 S.Orange Avenue mechanism Occurrence and Suite 900 Annual Orlando,FL 32801 Aggregate Note: K you are using the State Fund as any part of your demonstration of Anancial responsibigy,your execution and submission of this cert1kation also cerfts that you are M compliance with a0 condiBons forparticoaBon in the Fund. D. Facility Name Facility Address Market Street Cmwash&Gas 4411 Market Street,Ventura,CA 93003 Facility Name Facility Address Johnson Drive Cwwash&Gas 2757 Johnson Drive,Ventura,CA 93003 Facility Name Facility Address H Street Chevron and Market 2301 H Street,Bakersfield,CA 93301 E. Signature of Tankf Owner or Operator Date Name and Title of Tank Owner or Operator BY: �� r� �rLl. "EX�c.�P—cFo "/��► Signture of npWitness or Navy ,,r �Drate Name of Witness or Notary Gajlfl 'tom �'i 1* 11 CFR(Revised 04/95) FII.E: Original-Local Agency Copies-Fasility/Ste(s) NOTE: Effective July 1, 1995, California Small Businesses and California Businesses with 500 employees or less must demonstrate at least $5,000, exclusive of the UST Cleanup Fund, businesses with over 500 employees must demonstrate at least$10,000.(Chap.6.75 H&SC,Sect.25299.32) The Chief Financial Officer or the owner or operator must sign, under penalty of perjury, a letter worded EXACTLY as follows or you may complete this letter by filling in the blanks with appropriate information: LETTER FROM CHIEF FINANCIAL OFFICER I am the Chief Financial Officer for NNN Development. Inc., which is the sole member of NNN CA AutoiSve LLC, located at 450 S.Orange Avenue, Suite 900,Orlando, FL 32801. (Business name,business address,and correspondence address of owner or operator) This letter is in support of the use of the Underground Storage Tank Cleanup Fund to demonstrate financial responsibility for taking corrective action and/or compensating third parties for bodily injury and property damage caused by an unauthorized release of petroleum in the amount of at least$10,000 per occurrence and $10,000 annual aggregate coverage. (Dollar Amount) (Dollar Amount) Underground storage tanks at the following facilities are assured by this letter: Market Street Carwash&Gas,4411 Market Street, Ventura,CA 93003 and Johnson Drive Carwash&Gas,2757 Johnson Drive,Ventura,CA 93003 and H Street Chevron and Market,2301 H Street, Bakersfield,CA 93301 and Sparkling Image Car Wash/Pennzoil Lube Center, 1701 Stine Rd, Bakersfield,CA 93309 and Mission Car Wash, 1601 San Fernando Rd, San Fernando,CA 91340 (Name and address of each facility for which financial responsibility is being demonstrated.) 1. Amount of annual aggregate coverage being assured by this letter.............................................................................. $ 10,000 2.Total tangible assets.................................................................. $.-1 �>8,0M 3.Total liabilities.......................................................................... $ 7g3.0M v 4.Tangible net worth(subtract line 3 from line 2. Line 4 must be at least 10 times line 1).................................... $ '�� q I hereby certify that the wording of this letter is identical to the wording specified in subsection 2808.1(d)(1), Chapter 18,Division 3,Title 23 of the California Code of Regulations. I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge and belief. Executed at Orlando, FL On (Place of Execution) (Date) ay./Z- (Signature) B A�91 N (Printed Name) Exec. ✓f'-C Fo (Title) UST 02FR revised 0/95