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<br />ï 7~ <br /> <br />æ; ~ O.'al <br />= = 0 ngm <br />::- '!; 0 Regional Office <br />.......~ Copy <br />--- - <br />THRce TEXAS NATURAL RESOURCE <br />Protecting Texas CONSERVATION COMMISSION <br /> <br />by Reducing and <br />- ~ Preventing Pollution <br /> <br /> <br />PETROLEUM STORAGE TANK RENIEDIATION FUND <br />APPLICATION FOR REIMBURSEMENT <br />E-Z Form <br /> <br /> <br />Applicant (Company): City of San Marcos <br />Address: 630 East Hopkins Street <br />(City) San Marcos (Srate) Tx (ZIP) 78666 <br />Facility Name: <br />Facility Address: 630 East Hopkins Street < <br />(City) San ~1arcos (Srate) Tx (ZIP) 78666 <br />County: Hays <br />Leaking Petroleum Storage Tank (LPST) ID No.: g?hRO <br />TNRCC UST Facility Registration No.: 21680 <br />TNRCC UST Owner Registration No.: <br /> <br /> <br />Submit the original completed Application For Reimbursement including all <br />supplementary worksheets to: <br /> <br /> <br />Texas Natural Resource Conservation Commission <br />Petroleum Storage Tank: Division <br />P,O. Box 13087 <br />Austin, Texas 78711-3087 <br />Attn: Reimbursement Section <br /> <br />One additional copy of the Application for Reimbursement must be submitted to the <br />appropriate Texas Natural Resource Conservation Commission Regional Field Office for <br />the Region where the tanks covered by the application are located. Indicate in the box <br />above in the right hand corner if this is the original application, or the Regional <br />Office copy. <br /> <br /> <br /> <br />TNRCC APPLICATION FOR REIMBURSEMENT E-Z FORM: <br />TNRCC-0230-EZ (II-Ol-94) <br />