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<br /> '"'" <br /> bfJ 6- <br /> Mailing address: N/A <br /> Phone: <-) <br /> <br /> 5. List the number of tanks, the size, and the contents of each tank at the facility for which reimbursement is being sought <br /> in this application. If the tanks were removed and/or abandoned note which ones were removed and/or abandoned and <br /> the date(s) they were removed from service: <br /> Tank No. Capacity (ga1lons) ContentS (gasoline, diesel, etC.) Removed and/or Date Removed <br /> Abandoned from Service <br /> (indicate which) <br /> 1 1/9 I <br /> 3,000 Diesel 3/89 <br /> 2 3,000 Diesel 1/91 <br /> ~ / SN <br /> 3 <br /> 10,000 r..", ",n 1 ; np 1 /01 3/89 <br /> 4 10,000 l/ql <br /> Casoline ~/Qa <br /> -, <br /> 5 <br /> 6 { <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> 11 <br /> 12 <br /> 6. @YNO Have the tanks from which the release occurred been registered with the TNRCC? If yes, <br /> provide the facility registration number assigned by the TNRCC: <br /> If no, please note that all tanks that are subject to the registration requirements must be <br /> registered and tank registration fees paid before the reimbursement check can be released. <br /> 7. @/NO Have the tank owner(s) and/or operator(s) registered with the TNRCC all other tank systems in <br /> Texas which they knowingly own or operate? <br /> 8. @/NO Have the tank owner(s) and/or operator(s) paid in full all annual tank registration fees due since <br /> September 1, 1987 for all tanks which they own or operate? If no, please note that all <br /> outstanding fees must be paid in full before the reimbursement check can be released. <br /> TNRCC APPLICATION FOR REIMBURSEMENT E-Z FORM 5 <br /> -rN"C7rr..n7'?1?-1';7. (/1-01-1)4) <br />