Res 1998-049 - Laserfiche WebLink

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SECTION I. APPLICATION (continued) 4. .r..ES I NO Have all the tanks at this focility been registered with the Th"RCC? If yes. provide the facility registration number assigned by the TNRCC: 21680 If 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 formore information.) Also, note that tank registration fees must be paid before the reimbursement check can be released. 5. YESINO Have the tank owner(s) and/or operator(s) registered with the TNRCC .all ~ tank systems in Texas which they knowingly own or operate? 6. :IESJ NO 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 aU outstanding fees must be paid in fuU before the reimbursement check can be released. 7. YES./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: . Business receipts or invoices from the person who performed the work. indicaaiog payments received; . Canceled checks (copies, front and back); . An affidavit signed by the person who performed the wode affmning that the amounts which the applicant represents a<; being paid to him were paid in full. If the contractor has accepted a promissory note as "payment". a copy of the Promissory 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 I..NO Have you assigned your reimbursement payment? If yes, please complete the Notice 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), Q), and (k)(l)(2) to see if the assignment is valid. 9. XES/NO All of the petroleum storage tanks that are subject to registration requirements are registered with the lNRCC and all annual tank registration 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 1m! Have new tanks been installed at this site? If yes, when: l---.i_. 11. YES 1m! Have any upgrade or new installation activity costs been included in the total reimbursement request listed on line 3, page 13 of this application? 'INRCC APPUCA110N FOR REIMBURSEMENT E-Z FORM 4 1NRCC-0230-EZ (Revised09-O1-9S)