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<br /> 31~ :. <br /> . <br />9. YES@ Is this the first request for reimbursement of corrective act:on expenses incurred in reslxmse to . <br /> this release incident? <br /> a. If yes: . <br /> i. Enter the total costs for work performed: ............ <br /> $ . <br /> <br /> Please note that costs for work performed prior to September 1, 1987 are not <br /> reimbursable. For invoices that overlap this date, costs must be separated as to the ~. <br /> date work was performed and not by invoice date or date paid. <br /> b. If no: . <br /> i. How many previous claims for reimbursement for this release incident have been <br /> submitted? Fifteen (15) . <br /> ",' ..', ",','" <br /> "',,"':", "',:,:,,::':" <br /> Provide the total of all corrective action expenses previously " " ' " ,', ," " <br /> :,':',':"."", '~:,::,;\})j;;:{:;;~;g~ <br /> submitted for reimbursement for this release incident to date: ;~f,:~52';~:~:i;.:~:W:;':,,-: . <br /> <br /> ii. Have any expenses listed on this application for reimbursement been previously <br /> submitted for reimbursement? If yes, identify these costs by item and previous . <br /> application: <br /> i <br /> . <br /> <br />10. The TNRCC has a required owner/operator contribution or "deductible" that must be met before costs can be II <br /> reimbursed. The required deductible is based on how many single petroleum storage tanks the applicant owns or . <br /> operates in Texas when the application is determined to be arlmini~tratively complete at the TNRCC. The deductible <br /> is required only on the first application submitted for each Occurrence (LPST ill Number). The deductible, or <br /> "owner/operator contribution" will be as follows: : <br /> ; <br /> \ <br />a. REQUIRED NUMBER OF SINGLE PETROLEUM STORAGE TANKS APPLICANT OWNS OR OPERATES IN TEXAS <br /> DEDUCTIBLE <br /> ($) <br /> $ 1000 less than 13 tanks; <br /> $2500 13 to 99 tanks, inclusive; <br /> $5000 100 to 999 tanks, inclusive; or <br /> ~ <br /> $10,000 1,000 or more tanks. t <br /> II. <br /> ( Air p o.r t) <br />b. Number of single petroleum storage tanks owned or operated in Texas: 3 <br /> .. <br />c. Enter required deductible if this is the first reimbursement claim $ N/A . <br /> . . . . . . . . . , <br />TNRCC APPLICATION FOR REIMBURSEMENT E-Z FORM 6 . <br />TNRCC-D230-EZ (lJ..f)J-94) <br />