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Payment Summary Page 1 of 1 <br /> Claim No: 11775 Claimant: HELEN HIIGGINS , <br /> Request No: 10 Reviewer: Mart Owens%t0 <br /> Region: 5 Date: 1011412004 <br /> 1:v6" Invo" 1237237.. <br /> El lble F <br /> ethird Party_ l?end#�$- ifietiOW Notes <br /> N/A 02/05/02 35 It appears MW#5A and#5B is to be utilized for the investigation <br /> on non-petroleum contaminants-future costs associated with <br /> this investigation will be ineligible for funding(refer to footnote). <br /> RTAC=$190.2 N/A 04/01/02 0 See above oomment.3 NIA 05102!02 0 200.00 35 Lab analyses for non petroleum contaminants ineligible-see <br /> footnote.4 NIA 07/01102 0 0.00 <br /> 5 WA 0=2102 2,669.75 1,769.75 900.00 See above comment. <br /> 6 NIA 09/04/02 760:00 760.00 0.00 ,,wt <br /> 7 WA 11/01102 95.00 95.00 0.00 <br /> 8 NIA 04/03/03 142.50 142.50 0.00 <br /> 9 NIA 05/05/03 3,571.35 2,509.35 1,062.00 Ineligible lab analyses for non-petroleum contaminants. <br /> 10 NIA 06/02/03 855.00 855.00 0.00 <br /> 11 N/A 07/01/03 275.00 275.00 0.00 <br /> 12 NIA 11/05/03 3,469.35 2,407.35 1,062.D0 Ineliigble lab analyses for non-petroleum contaminants. <br /> 13 NIA 12102103 760.00 760.00 F <br /> 14 NIA 03102!04 285.00 285.00 -IMPORTANT NOTE: FOR FUTURE REQUESTS.ONLY A <br /> PORTION OF COSTS FOR GROUNDWATER MONITORING WILL <br /> BE REimtjuK-%iAbtk-BECAUSE 1)INVESTIGATION OF NOW <br /> PETROLEUM HYDROCARBONS,AND 2)ESSSENTIALLY NON- <br /> DETECT CONTAMINANT LEVELS IN ALL WELLS BUT#3. " #3 <br /> CHECK WITH REGULATORY AGENCY FOR POSSIBLE SITES <br /> CLOSURE. <br /> AlmSutstotals 1�d,$ 9� 0 ci <br /> Previous ReirnbursementTotals: 77,021.68 0.00 <br /> Current RebnbursemenY 11,665.95 <br /> Neva Reirrrbursenr3tttotsts 8$6$T53 p Ofi Carry,these amounts forward to the next'Spreadsheet"In the <br /> - ,+ "Amount Requested,Previous Total"and"Third Party Costs"columns. <br /> FOOTNOTES <br /> 35- NON-PETROLEUM CONTAMINANTS <br /> The costs associated with Investigating and remediating non-petroleum contaminants are not eligible for funding. The Fuad is only authorized to reimburse <br /> reasonable and necessary corrective action costs resulting from an"unauthorized release"of"petroleum,"as those terms are defined in Fund Regulation 2804. <br /> Section 2812.1.(b)requlres three bids for any work after December 2nd,1991,or cost eligibility may be compromised. Page 1 of 1 <br />