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<br />[tl" <br />'............'..'...'. """. <br />I:. ' <br />','.. <br />RECYCLE <br />USED OIL <br /> <br />2006/2007 Used Oil Recycling Block Grant Application (lzth Cycle) <br />Application Due Date: Postmarked on or before June 1,2006; <br />Hand-delivered applications received by 3:00 p.m. on or before June 1,2006 <br /> <br />Applicant: (If a regional program, list lead agency first and addlcross outjudsdictions that have changed status) <br /> Pleasanton <br /> Estimated Total Grant Amount: $ 17319 <br />Address: New Address: (If changed) <br />3560 Nevada Street <br />Pleasanton, CA 94566 <br />Primary Contact: New Primary Contact: (If changed) <br /> Danielle Stefani <br /> Printed Name of Primary Contact Printed Name of Primary Contact <br />Title: Hazardous Matedals Coordinator Title: <br />Phone: 925-454-2338 Phone: <br />E-Mail address: dstefani@lpfire.org E-Mail address: <br />Fax: . Fax: <br />925-454-2367 <br />Signature Authority(as designated in Resolution): New Signature Authority: (If changed) <br /> Bill Codv ND1Aon Finllan <br /> Printed Name of Signature Authority Printed Name of Signature Authority , <br />Title: Fire Chief Title: Ci:ty Managel\. <br />Phone: 925-454-2300 Phone: 925-931-5002 <br />E-Mail address: bcody@lpfrre.org E-Mail address: <br />Fax: 925-454-2367 Fax: 925-931-5482 <br />State Senate Dist: In State Assemblv Dist: 11 Conntv: .. . <br />Consultant: (If applicable) New Consultant: (If applicable andlor changed) <br />Contact Name: Contact Name: <br />Phone: Phone: <br />E-Mail address: E-Mail address: <br />Fax: Fax: <br />Advance Payment Option: For Grantees receiving $20,000 or less, and multi- o Elect advance payment option <br />jurisdictional and regional grantees whose individual jurisdictions would have received 520,000 <br />or less had tbey applied individually - advance payment is available. <br />Certification <br />I declare, under penalty of perjury, that all infonnation submitted for the California Integrated Waste Management Board's <br />consideration for allocation of grant funds is true and accurate to the best of my acknowledge and belief. <br /> Ci:ty Managel\. <br />Authorized Signatory Title Date <br /> <br />Mail To: California Integrated Waste Management Board, Attention: Grants Administration Unit MSIO; BG (12'" <br />Cycle) for FY 2006/2007; 10011 Street, P.O. Box 4025, Sacramento, CA 95812-4025 <br />ATTACHlofENT A <br />