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<br />~ bO~ <br /> <br /> <br /> <br />- <br /> <br />æ::::r -= 0 Oriolnal <br />- -- 0' <br />=- ~ 0 Regional Office <br />~~ Copy <br />8r-JII <br /> <br />TNRCC TEXAS NATURAL RESOURCE <br />Protectin~Texas CONSERVATION COMMISSION <br /> <br />by ReducIng and <br />Preventing Pollution <br /> <br /> <br /> <br />PETROLEUM STORAGE TANK REl\1EDIATION FUND <br />APPLICATION FOR REIM:BURSEl\1ENT <br />E-Z Form <br /> <br /> <br />Applicant (Company): City of San ~1arcos <br />Address: 630 East Hopkins Street <br />(City) San Marcos (State) Tx (ZIP) 78666 <br />Facility Name: <br />Facility Address: 630 East Hopkins Street . <br />(City) San M3.rcos (State) 'T'x (ZIP) 7Rhhh <br />County: Hays <br />Leaking Petroleum Storage Tank (LPST) ID No.: 92680 <br />TNRCC UST Facility Registration No.: 21680 <br />TNRCC UST Owner Registration No.: <br /> <br /> <br />Submit the original completed Ápplication For Reimbursement including all <br />supplementary worksheets to: <br /> <br /> <br />Texas Natural Resource Conservation Commission <br />Petroleum Storage Tank Division <br />P.O. Box 13087 <br />Austin, Texas 78711-3087 <br />Attn: Reimbursement Section <br /> <br />One additional copy of the Application for Reimbursement must be submitted to the <br />appropriate Texas Natural Resource Conservation Commission Regional Field Office for <br />the Region where the tanks covered by the application are located. Indicate in the box <br />above in the right hand corner if this is the original application, or the Regional <br />Office copy. <br /> <br /> <br /> <br />TNRCC APPUCATION FOR REIMBURSEMENT E-Z FORM <br />TNRCC-0230-EZ (11-01-94) <br />