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Claimant Sheet Claimant: OLIVAREZ PROPERTY Pre Approval Specific Reimbursement Request <br /> Claim No: 8492 Pre-Approval No:3 <br /> Request No: Date:July 9,2002 Pre-Aooroved Costs <br /> Region: 5 Pre-Aouroved Task Amounts from Pre-ADaroval No.3 dated 07109102 <br /> Pre-Approval No:3 FPayment Verification Task no.1 Task no.2 Task no.3 Task no.4 Task no.5 <br /> Pre-Approval Date:Jul 9,2002 $12,554.00 $0.00 $0.00 $0.00 $0.00 <br /> Invoice Invoice Invoice Amount Check Check Check <br /> i Installation of One <br /> Extraction Well, <br /> Permitting, <br /> j Sampling,Pump <br /> Payee No. Date Amount Requested No. Date Amount Test and Disnosal <br /> revious Total(Last Reimbursement) <br /> I <br /> 2 <br /> i <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> Il <br /> 12 <br /> 13 <br /> 14 <br /> 15 <br /> iubtotal Sheet 1 $0.00 $0.00 .$0.00 F_$0.00 $0.00 $0.00 $0.00 $0.00 <br /> 1i Total Pre-Approved Costs remaining on each Task $12,554.00 $0.00 $0.00 50.00 50.00 <br />