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VII. PRIORITY CLASS WORKSHEET A. F THfRE ARE NO JOINT CLAIMANTS,PROCEED TO SECTION Wb. WHEN JOINT CLAIMS ARE SUBMITTED,THE CLAIM SMALL BE BASED ON TH1E LOWEST PRIORITY APPROPRIATE FOR ANY JOINT CLAIMANT UST PRIMARY CLNMANT AND ANTJOMTCLAIMMM. IDENTS'THE ARPROPRIATE PRIORITY CLASS FOR ALL JOINT CLAIMANTS NAME OWNER OPERATOR DATES OF OV/NEISFEPIOPERATION PRIORITY CLASS El 77FROM: TO [:]A ❑S ❑C F7 PRSMYIY CLAMANT ❑ ❑ FROM TO: ❑A ❑B ❑C ❑D-'� JOINT CLASWIT II ❑ ❑ FROM: TO! ❑A ❑B ❑O C0 I JONTCLAYANT ❑ ❑ mom: T0: ❑A L'IB ❑C LA0 ! JOINTCLAMANT - B. WHERE ANY CLXMANT IS EITHER THE OWNER OR OPERATOR(BUT NOT BOTH AT THE TIME OF DISCO`EITY OF THE UNLAUR/OV=RELEASE.OR W-FRE ANY CLAIMANT IS EITHER THE CURRENT OWNER OR OPERATOR(BUT NOT BOTM AND WHERE SUCH OPERATOR AND OWNER WOULD BE EUGBLE TO SUBMIT A CLAIM TO THE FUND FOR COSTS PND CA INCLARED BY SUCH OPERATOR OR OWNER.THE CLAIM SUBMITTED SY EITHER SMALL BE BASED ON THE THE LOWEST PRIORITY APPROPRIATE FOR EITHER. - F ANY CLAIMANT WAS ET/EA THE ORVNIER 011 THE OPERATOR OUT NOT BOTH)CP THE TAW(S)AT THE TIME OF DISCOVERY Of THE UNAUTHORIZED RELEASE, IDENTIFY THE OTHER RERSONIS)AND THEIR APM40FRATE PRIORITY CLASS: ❑ ❑ FROM: TO: ❑A ❑B LJ C 0 IF ANY CLAIMANT IS ETHER THE CURRENT OWNER CA OPERATOR OF THE TANKS)OUT NOT BOTH,IOBliFY THE OTHER PEPISON(S) AND THIBR APPROPRIATE PRIORITY CLASS: ❑ ❑ FR04-. To: ❑A ❑B ❑C ❑0 C. PRIORITY CUSS CLAIMED: BASED ON CONSIDERATION OF THE PRIORiIES OF FIERSON(S)IDENTIFIED IN A OR C AWA AND REVIEW OF PROMW"FORMATION.PRIORITY CLA59, INDICATE THE PRICAITY CLASS SOUGHT BY THE CLAIMANT FOR THIS CLAIM: ❑ ARESIDENTIAL p SM a B .SMALL BUSINESS ❑ C. OTHER BUSINESS ❑ 0.ALL OTHER AND 79ATpAW OWNERS HOMEHEATING RS V11I. PRIORITY CLASS DESIGNATION A. IF CLAIMING CLASS A CHECK THE APPROPRIATE BOX: Al ❑UNDERGROUND STOtKE TAN(ON RESIDENTIALLY ZONED PROPERTY THAT M WM ALL OF THE FO LOW014 AI cL uMANT E OWNER OF UNOEAORONU STOMOE TAW RI01/MRPON AN U AVrHD t=R6EAM OF MMOL13JM 442 OCCLMIED M TANK■LOCATED AT THE RDCO CK OF A PERSON YA*N THE UN&VT4O%ZED ABLEAN WAS DKCO%IM Q WHEN L*VATTHORSM RELEASE WAS OSCOVEIED PROPERTY WHERE TANK IS LOCATED WAS WM ROIED h OWNER OCCL M SINGLE FAWY 0 WELJNG ORDURE[ 01 TANK■LOCATED ON PROPERTY ZONED ONLY MR 1ESMENTAL RAE WHEN LNAVTWALZED RELEASE WAS DMCCVSEO O TAN(WAS NOT USED TO STOAE MOTOR YEMCLE FUEL MMARILY FOR AGACU.TLAAL USE OR FOR RESALE ON OR AFTER JANIARY I,+get A2 ❑SWILL HOW HEATING OIL TAN!THAT METS ALL Of THE FdlOYdNQ AI CLAIM R OWNER OF LWDOCRDLPJD STORAGE TANK FROM WHICH AN uMUTHORIIO REMAKE OF MME NEAnw oK.w oCCUiIED m TANK E LOCATED AT THE RDDENCE OF A PERSON WFkH THe UAVTHORDD RELEASE WAS 0607YEED CI W NEN UMUn10R2E0RELEASE WAS OMCOVEED PROAEAT/WHEE TANK a LOCATED WAS IWRWED SY ONREM OCCUPIED SWOIE FAIRLY 0 WELLM OR MOLD M TANK NAS A CAPACITY OF T IM GALLON OR LESS E)TAN(6 USED ONLY TO STORE MME HEATM OL FOR W NSLAAFTNE USE OR PADPERRY F)TRIAL b NOT LOCATED ON PROPERTY USED FOR AGRCULTLIF L NASO AFTER JANIAM I.I M NOTE REFER TO APPLICATION INSTRUCTIONS FOR REQUIRED DOCUMENTATION TO SUPPORT THE ABOVE CLAIMED STATEMENT. THIS DOCUMENTATION MUST BE SUBMITTED AT THE TIME OF APPLICATION. �A7c a vEW q9+I