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<br /> SECTION IV. TOTAL REIMBURSEMENT REQUEST <br /> 1. YES/~ Is this the fIrSt request for reimbursement of corrective action expenses incurred in response to this release incident? <br /> a. U yes: <br /> i. Enfur the total costs for work performed: <br /> ...............................,. ..........................,.... <br /> Please note that costs for work performed prior to September It 1987 are not reimbursable. For invoices that <br /> overlap this date, costs must be separated as to the date work was performed and. not by invoice date 01' date <br /> paid. <br /> b. Uno: <br /> i. How many previous claims for reimbursement for this release incident have been submitted? <br /> TwenQr-three (23) <br /> <br /> Provide the total of all cOJreCtive action expenses previously submitted for reimbursement for this release incident <br /> to date: <br /> .............................................,................. <br /> Ü. Have any expenses listed on this application for reimbursement been previously submitted for reimbursement? <br /> H yes, identify these costs by item and previous application: <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> TNRCC APPUCA TION FOR REIMBURSEMENT E-Z FORM 11 <br /> TNRCC-O230-EZ (Revised 09-01-95) <br />