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<br /> I 63 <br /> TEXAS NATURAL RESOURCE <br /> I ...... CONSERVATION COMMISSION <br /> - -- <br /> - - <br /> - -- <br /> I . PETROLEUM STORAGE TANK <br /> REMED IA TI 0 N FUND <br /> I TNRGG APPLICATION FOR REIMBURSEMENT <br /> E-Z Fonn <br /> , Protecting Texas <br /> by Reducing and <br /> Preventing Pollution <br /> If <br /> I Applicant (Company): City of San Marcos <br /> Contact Person: Frances Plocek <br /> I Phone: Ul2) 393-8010 Fax: (ill) 392-2625 <br /> Mailing Address: 630 East HQpkins Street <br /> I (City) San Marcos (State) Tx (ZIP)78666 <br /> FacilityName: <br /> , Facility Address: 630 East HQpkins <br /> (City) San Marcos (State) Tx (ZIP)78666 <br /> I County: H!tVs <br /> Leaking Petroleum Storage Tank (LPST) ID No.:92680 <br /> I TNRCC UST Facility Registration No.: 21680 <br /> TNRCC UST Owner Registration No.: <br /> I Is this the first request for reimbursement for this release? No If no, how many previous <br /> claims have been submitted 24 and total costs of all previous claims $ 2,078,234.78 <br /> I, Total Cost of this Application (Section V) $ 6,045.49 <br /> Total Reimbursement Request (Section IV)$ 6,045.49 <br /> <br /> Number of single petroleum storage tanks owned or operated in Texas: 3 <br /> I <br /> 0 Check here if the TNRCC bas preapproved the work described in this application. The TNRCC will <br /> I reimburse only those costs that have been preapproved by the region inspectorlRPR coordinator. <br /> (Preapproval documentation must be submitted with this application.) <br /> I Submit the original completed Application For Reimbursement including all Schedule A worksheets to: <br /> Texas Natural Resource Conservation Commission <br /> Reimbursement Section, MC 139 <br /> Petroleum Stomge Tank Division <br /> I P.O. Box 13087 <br /> Austin, Texas 78711-3087 <br /> (512)239-2001 <br /> I Submit one copy of this Application to the appropriate TNRCC Regional Field Office. <br />