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<br /> TEXAS NATURAL RESOURCE 66 <br /> --.. CONSERVATION COM MISSION <br /> - - <br /> - - <br /> - - <br /> - -- <br /> . PETROLEUM STORAGE TANK <br /> REMEDIATION FUND <br /> THRee APPLICATION FOR REIMBURSEMENT <br /> E-Z Form <br /> Protecting Texas <br /> by Reducing and <br /> Prev8l1ting Pollution 'ALLj.....SMllS'l' BE co~lra..- __"~A ";;;~ ÅWLICA~ . <br /> ..WILL BE It£TUIt1!ŒD.Mr toGwMMtt--.ç..17~_""~~ , . .,. '." <br /> Applicant (Company): Ci~ of San Marcos <br /> Contact Person: Frances Plocek <br /> Phone: (ill) 393-8010 Fax: (ill) 392-2625 <br /> Mailing Address: 630 Ea~t Hopkins Street <br /> (City) San Marcos (State) Tx (ZIP)7~666 <br /> Facility Name: <br /> Facility Address: 630 Ea~t Hopkin~ <br /> (City) San Marcos (State) Tx (ZIP)78666 <br /> County: Hays <br /> Leaking Petroleum Storage Tank (LPST) ID No.:92680 <br /> TNRCC UST Facility Registration No.: 21680 <br /> TNRCC UST Owner Registration No.: <br /> Is this the first request for reimbursement for this release? No [f no, how many previous <br /> claims have been submitted 26 and total costs of all previous claims $ 2,695,619.22 <br /> Total Cost of this Application (SectiOQ V) $ 8,610.33 <br /> Total Reimbursement Request (SectiOQ N)$ 8~610.33 <br /> Number of single petroleum storage tanks owned or operated in Texas: 3 <br /> <br /> D Check here if the lNRCC bas preapproved the work described in this application. The lNRCC will <br /> reimburse only those costs that have been preapproved by the region inspectorlRPR coordinator. <br /> (Preapproval documentation must be submitted with this application.) <br /> Submit the original completed Application For Reimbursement including all Schedule A worksheets to: <br /> Texas Natural ResoUIœ Conservation Commission <br /> Reimbursement Section, MC 139 <br /> Petroleum Storage Tank Division <br /> P.O. Box 13087 <br /> Austin, Texas 78711-3087 <br /> (512)239-2001 <br /> Submit one copy of this Application to the appropriate TNRCC Regional Field Office. <br />