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<br /> (;;0# <br /> SECTION V. REIMBURSEMENT CLAIM SUM:MARY <br /> Please check the appropriate Reimbursement Activity Summary Cost Sheet boxes you have completed for this application for <br /> reimbursement. Provide the subtotal cost for each Cost Sheet (Schedule A) submitted. Please see the back of Schedule A <br /> (Reimbursement Activity Summary Cost Sheet) for additional instructions. <br /> 0 ACTIVITY-01:INITIALABATEMENT ......................... SUBTOTAL $ t:'iW:::tf'J1WH.fMItt'lt:lNftm,'tJi'WWWW <br /> """"""""""""""""""""""""""""""""...m...... <br /> 0 ACTIVITY-02:TANKREMOVAL ............................ SUBTOTAL $ r:::,:t::,:tt:tI:'@:,:,$:':"11,rrrrr:,:t'l:g:;:g::;j';':'~r;:;j::"::'Mj <br /> ..................... . ................. .. """" ................. <br /> 0 ACTIVITY - 03: EXCAVATION .............................. SUBTOTAL $ lif&f&#NihNWfffttmW@f!Wtrt1¡p@::,@,:g <br /> 0 ACTIVITY-04: WASTE TREATMENT ......................... SUBTOTAL $ }tttt='N{::::;i:rtlf:f:t::~f:Wëtmmf:l;r/f{,'¡W':ë":; <br /> 0 ACTIVITY - 05: SITE ASSESSMENT .......................... SUB TOT A L $ @tw'¡~m¡¡m:::"Wt'H:::¡::::~R:;{if::gWHffgfWit <br /> <br /> 0 ACTIVITY-06:RISKASSESSMENT .......................... SUBTOTAL $ N::Ë:m":"'::"r"m:W::Mrmø¡;¡f')'{#~r:::tf¡¡Wfti <br /> <br /> 0 ACTIVITY-07:AQUIFERTESTING ........................... SUBTOTAL $ i'i,:?'tfJr:':rrmŒMi'¥ëárffMmff@~:¡:Mf::::::'f:Æ':: <br /> i"""""""""""'" ............ "".............................. <br /> 0 ACTIVITY - 08: SOIL VAPOR EXTRACTION PILOT TEST. . . . . . . . . . .. SUB TOT A L $ r:,::tt:,j;;:j,j:;:'Œrre':11}';FHŒWim:tWffr::t','¥@f; <br /> IX] ACTIVITY - 09: QUARTERLY MONITORING. . . . . . . . . . . . . . . . . . . .. S U 8 TOT A L $ ih't'@'Ç55'4'JSZfiI:'W?J:::IWmWnHiRf'r', <br /> <br /> 0 ACTIVITY - 10: REMEDIAL ACTION PLAN PREPARATION. . . . . . . . . .. SUB TOT A L $ :W¡j:j:;W¡r:tn~a¡j::';tmN:{.wWWŒf}:,::::,,:qrr:l(:' <br /> 0 ACTIVITY - 11: GROUNDWATER EXTRACTION & TREATMENT. . . . . .. S U 8 TOT A L $ ¡f¡¡¡::':!:mH':f::m;n:wm¡W~:!w*:':t¡NWWM!it'Wm <br /> <br /> 0 ACTIVITY-12:S0ILVAPOREXTRACTION """""""""'" SUBTOTAL $ <br /> rz¡ ACTIVITY - 13: OPERATION AND MAINTENANCE """""""" SUBTOTAL $ :,è:ttB~1m:è9{;":I?I?)Y;r:;/:::::;::::::;:':::;:;:;:::'::r:: <br /> 0 ACTIVITY-14:SITECLOSURE.............................. SUBTOTAL $ r'n:'}:N'mt?':?¡¡;::¡::;:'¡¡W:H:f~"f'i'¡'H#¥~':¡"'::¡~~W{¡'¡::,:;: <br /> <br /> TOTAL AMOUNT REQUESTED IN THIS APPLICATION ........... $ 16,643.90 <br /> WRITE OUT THE TOTAL REIMBURSEMENT REQUESTED AMOUf\lT: <br /> ::;ixteen thousand six-hundred forty three and 90/100-----------------D-Q"CCAR-S- <br /> <br /> TNRCC APPLICA nON FOR REIMBURSEMENT E-Z FOlUvf 14 <br /> TNRCC-O230-EZ (11-01-94) <br />