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6off 9. YES 8 Is this the f:irst request for reimbursement of corrective acf.on expenses incurred in response to this release incident? a. If yes: .. ", , ...,.. , , i. Enter the total costs for work performed: ............ :::/:/;;,:,:,:}=/~::?. }$" Please note that costs for work performed prior to September 1, 1987 are not reimbursable. For invoices that overlap this date, costs must be separated as to the -'~ date work was performed and not by invoice date or date paid. b. If no: i. How many previous claims for reimbursement for this release incident have been submitted? Seventeen ( 17) .' Provide the total of all corrective action expenses previously submitted for reimbursement for this release incident to date: ii. Have any expenses listed on this application for reimbursement been previously submitted for reimbursement? If yes, identify these costs by item and previous application: , 10. The TNRCC has a required owner/operator contribution or "deductible" that must be met before costs can be reimbursed. The required deductible is based on how many single petroleum storage tanks the applicant owns or operates in Texas when the application is determined to be administratively complete at the TNRCC. The deductible is required only on the first application submitted for each Occurrence (LPST ill Number). The deductible, or "owner/operator contribution" will be as follows: a. REQUIRED NUMBER OF SINGLE PETROLEUM STORAGE TANKS APPLICANT OWNS OR OPERATES IN TEXAS DEDUCTIBLE ($) $1000 less than 13 tanks; $2500 13 to 99 tanks, inclusive; $5000 100 to 999 tanks, inclusive; or $10,000 1,000 or more tanks. b. Number of single petroleum storage tanks owned or operated in Texas: 3 (airp:>r:t) c. Enter required deductible if this is the first reimbursement claim. . . . . . . . . TNRCC APPLICATION FOR REIMBURSEMENT E-Z FORM 6 TNRCC-0230-EZ ( 1-D1-94)