Laserfiche WebLink
<br /> SECTION IV. TOTAL REIMBURSEMENT REQUEST <br /> 1. YES I NO Is this the ftfst request for reimbursement of corrective action expenses incurred in response to this release incident? <br /> a. If yes: <br /> i. Enter the total costs for work performed: <br /> ............................................................... <br /> Please note that costs for work perfonned prior to September 1, 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 or date <br /> paid. <br /> b. If 00: <br /> i. How many previous claims for reimbursement for this release incident have been submitted? <br /> Twentv.five (25) <br /> <br /> Provide the total of all cotreCtive 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 /> If yes, identify these costs by item and previous application: <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> 'INRCC APPUCATION FOR REIMBURSEMENT E-Z FORM 11 <br /> 'INRCC-023O-EZ (Revised09-O1-95) <br />