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I 33W SECTION ID. RELEASE INCIDENT S{Thßt{ARY I Complete all appropriate blanks pertaining to the release incident for which reimbursement is being sought in this 'application: I ~NO For YES or NO answers, please circle response in the left hand column. 1. Date release occurred or discovered: / 02 / 89 I" 2. Date release was r~rted to the TNRCC: 02 / 24 / 89 . ames Bard To whom: - . I" ~/NO 3. Was this a confirmed release? 4. Describe the release detection method used: Excavation Wells I 5. Substance released: 0 gasoline; 0 diesel; 0 waste oil; 0 other: What amount was spilled? est-3000 gallons. I' 6, Impact on: 0 soil; 0 groundwater; 0 surface water; 0 utilities; 0 other. I 7. Date corrective action began at the site: / 02 / 89 . 8. Corrective action billing period for which reimbursement is sought in this application: I 04 / 01. / 95 to 06 / 30 / 95 . @/NO 9. Have any tanks been removed at this site? If yes: i I a. Date the tanks were removed: / 01 I q<; b. Number of tanks removed: Four (4) I @)NO 10. Were/are there phase-separated hydrocarbons present at this site? If yes: a. Amount recovered 'to date: 2606 gallons. b. Amount recovered during the billing period of this application none gallons. I t§) NO 11. Has any soil outside the tankpit been excavated from this site? If yes: I a. Amount of soil excavated to date: 3000 cubic yards. I b. Amount of soil excavated during the billing peiiod of this application: nonE". cubic yards. -~ / NO 12. Has any soil from this site been treated ? If yes: a. Amount of soil treated to date: 3000 I ~. ya,Yds b. Amount of soil treated during the billing period of this application: nonP. tons, I @/NO 13. Has any soil been hauled to a landfùl from this site? If yes: a. Amount of soil hauled to a landfill to date: 3000 -teas-. yards b. Amount of soil hauled to a landfill during the billing period of this application: nnnp tons. I §/NO 14. Have soil borings been drilled at this site? If yes: a. Number of borings drilled to date: 76 . I b. Number of borings tlrilled during the billing period of this application: none - I ..-. TNRCC APPUCATION FOR REIMBURSEMENT E-Z FORM 11 TNRrr-m10-EZ (11-01-94)