Res 1996-126 - Laserfiche WebLink

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] SECTION IV. TOTAL REIMBURSEMENT REQUEST (continued) §'tJ ] 2. The TNRCC has a ~ owner/operator contribution or "deductible" ~t must be met before costs can bè reimbursed. The require! deductible is based: - how many single ~troleum storage tanks the applicant owns or operates in Texas; ] if specific corrective ã.ction milestones are met: and the number of occurrences when the application is determined to be administratively complete at the TNRCC. ] An initial deductible is required for each Occurrence (LPST ill Number - the deductible may increase based upon the failure [0 meet specific corrective action milestones). The deductible. or "owner/operator contribution" will be as follows: ] leu I I I I "-ù'"MBER OF REQùìRED FAILCRE TO FAILURE TO FAILliRE TO $I?liGLE DEDUCTIBLE SU'B:\lIT A SlJ'B:\-1IT MEET PETROLEU:\í ($) SITE .~""'D RECEIVE THE GOALS IN ] STORAGE TA."'KS ASSESS:\fENT APPROVAL THE APPROVED APPLICA."';T O"'1';S PRIOR TO FOR CORRECTIVE OR 12123/96 CORRECTIVE ACTIO:-i PLA."{ OPERATES L"{ ACTION PLA.'" BY TEXAS PRIOR TO U123/98 ] 12/23/97 less than 13 tanks: - S 1.000 S 2.000 $ 4.000 $ 8.000 ] 13 to 99 tanks. inclusive: S 2.500 S 5.000 S10.0oo 520.000 I 510.000 I 100 to 999 tanks, inclusive: or S 5.000 520.000 $40 . 000 1 1.000 or more tanks. S10.000 $20.000 $40.000 $80.000 If a site has received a closure letter and has a subsequent release on or after 9/1/95. the deductible will be $50.000. I . ] a. Number of single petroleum storage tanks owned or operated in TexaS: ì (A i'[lfirt) b. Enter required deductible: J . . . .. . .. ..,.. . . . . . . . . .... . .. .. . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . .. $ N/A 3. Provide the following information in order to calculate the total reimbursement request for this application: J a. From the Reimbursement Claim Summary (Section V), provide the total cost for corrective action ~rformed: ] ..................................................,............, $20,n<:;6ó b. Enter the required deductible amount: 1 {Same as line (Lb.)}: ................................................. $ N/A For the corrective action expenses requested to bè reimbursed in this application, provide the amount of any private insurance c. reimbursement that has already been received for these ex~nses or for which a claim was filed prior to July 17, 1990: 1 J .. . . ... . .,.. . . .. .. . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . ... . . . . . . . . . . .. $ N/A Insur Ci ty of San Marcos; Larry D. Gilley, Ci ty Manager 1 er name: Policy number: .I ì As of / / (date), insurance reimbursement has been (check one): received c !aimed ! ~ I TOTAL REL\fBú'RSE~Œ~T REQUEST (3.a.) - (3.b.) - (3.c): ................. 20.785.66 1 1 7 T/'.'RCC APPLICATION FOR REß1B1..iRSE.'vŒ!'o"T E-Z FOR.\-! 11 Th"RCC-O23O-EZ (Revis.:d 09-01-95) ~