Res 1998-049 - Laserfiche WebLink

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SECTION I. APPLICATION (continued) 4. u.s./ NO Have all the tanks at this facility been registered with the 1NRCC? If yes. provide the facility registtation number assigned by the lNRCC: 21680 IT no. please note that after December 31, 1995 all USTs and ASTs must be registered with the lNRCC to be eligible for reimbursement (Refer to Guidance Manual for more infonnaôoo.) Also, note that tank registration fees must be paid before the reimbursement check can be released. 5. DS/NO Have the tank owner(s) and/or operator(s) registered with the TNRCC all gd1c1: tank: systems in Texas which they knowingly own or operate? 6. .ïES.JNO Have the tank owner(s) and/or operator(s) paid in full all annual tank registration fees due since September 1. 1987 for all tanks which they own or operate? If no, please note that all outstanding fees must be paid iD fuU before the reimbursement check can be released. 7. XES./NO Does the application contain acceptable evidence of proof of payment for all claimed expenses. Evidence of acceptable proof of payment may include the following items: 8 Business receipts or invoices from the person who performed the work. indicating payments received; 8 Canceled checks (copies. front and back); 8 An affidavit signed by the person who peñonœd the worlc affirming that the amounts which the applicant represents æ being paid to him were paid in full. If the contractor bas accepted a promissory note as "payment". a copy of the Pronrissory Note must be submitted with the affidavit; or 8 TIle certification of a certified public accountant that the expenses for which reimbursement is requested have been paid in full. 8. YES 1.Ml Have you assigned your reimbursement payment? IT yes, please complete the Noûce of Assignment and Assignment Contract found in the Appendix in the Reimbursement from the Petroleum Storage Tank Remediation Fund Guidance Manual. Please see page 13 in the Guidance Manual and refer to §334.302 (i), 0), and (k)(l )(2) to see if the assignment is valid. 9. YES / NO All of the pettoleum storage tanks that are subject to registraûon reqUÙ'ements are regístered with the lNRCC and all annual tank registtation fees due since September 1, 1987. have been paid in full. (Please note that all fees owed must be paid in full prior to the disbursement of the reimbursement check.) 10. YES I &l Have new tanks been installed at this site? If yes, when: I I_. 11. YES /lSQ Have any upgrade or new installation acûvity costs been included in the total reimbursement request listed on line 3, page 13 of this application? 1NRCC APPUCATION FOR REIMBURSEMENT E-Z FORM 4 1NRCC-O230-EZ (Revised 09-01-9S)