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<br />I SECTION ll. APPLICATION 53q <br /> m - 1_..' <br />1 . - <br /> L Name of Applicant: City of San Barcos <br />( Mailing address: 630 East Hopkins <br /> San MarCOS Tx 7R66h ~ <br /> (City) (St:l!c) (ZIP) <br />t Contact Person: Ray Di.nqes <br /> Phone: ~ 353-4444 Fax: (512 ) 3.9h-4h")h <br /> <br />- a. Applicant is a: (complete applicable blanks) <br />I Texas Corporation, provide Texas Tax ID No.: <br /> Federal Employer ill No. <br /> Corporation outside of Texas, provide Federal Employer ill No. <br />I Partnership, provide names and social security numbers for all partners: <br /> (name) (SSN) <br />I (name) (SSN) <br /> Individual, provide Social Security No.: <br />I Lending Institution, provide: <br /> Date of foreclosure: <br />- Other: Municipality <br /> i <br /> b. Applicant is the: (check all that apply) <br />I JO Tank system owner XI Tank system operator <br /> XI Facility owner 0 Land owner <br />, 0 Former owner 0 Former Operator <br /> 0 Lending InstitUtion <br />- 2. If the tank system owner or operator, the facility owner, the land owner, the former owner, the former operator, or the <br />, lending institUtion is different than the applicant shown above, then complete the appropriate spaces listed below: <br /> - <br />. a. Tank system owner: N/A <br /> Mailing address: <br /> Phone: L-) <br />. Dates of ownership: I I to I I <br /> <br />. ' N/A <br /> b. Tank system operator: <br /> <br /> Mailíng address: <br />. phone: <---.) <br /> Dates of operation: I I to I I <br />. TNRCC APPUCATION FOR REIMBURSEMENT E-Z FORM 3 <br /> TNRCC-D2:JD-EZ (11-01-94) <br />