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ii <br /> GENERAL INSTRUCTIONS FOR COMPLETING THE <br /> UST CLAIM APPLICATION <br /> E <br /> This Claim Application is for the use of eligible owners and/or operators 1of underground storage tank(s) who are <br /> - applying to the Underground Storage Tank Cleanup Fund Program for funds to be used for the cleanup of soil and I <br /> groundwater contamination caused by an unauthorized release of petroleum. Owners and/or operators must have paid a i <br /> ( for or will being paying for the corrective action costs. } <br /> Type or print clearly all required information. Be sure that all required documents are submitted with the Claim <br /> Application. Attach additional pages as necessary to explain responses. j <br /> I <br /> Where multiple owners and/or operators have paid for or are responsibiel for the payment of the cleanup, any one may <br /> claim the cost, all may claim the cost (i.e. partnership), or a joint claim may be submitted. However, only one claim <br /> can be submitted for the same cost. Where the claimant consists of multiple parties with common interest in the tank(s) <br /> and who share in the same cost of cleanup, such owner and/or operator should file as a single claimant. Where <br /> multiple owners and/or operators have paid for or are responsible for the�payment of different costs at the same site, j <br /> each may submit a claim for the costs that they have paid for or are responsible to pay, or they may consolidate the <br /> claims into a joint claim. <br /> I <br /> Sign and date the Claim Application on the last page as indicated. All claimants must sign, including any joint F <br /> claimants. <br /> Send the originally signed application with one copy of each of the supP,, rung documents (retain originals). Before <br /> mailing, be sure to make a copy of the entire application package and retain this copy for your records. To confirm 3 <br /> delivery, it is suggested that the Claim Application be mailed certified, return receipt requested. Applications may not <br /> be submitted by facsimile or through other electronic means. t <br /> If you should have any questions concerning this Claim Application, please call the UST Cleanup Fund at (916) 227- <br /> 4307. <br /> 4 ' <br /> 4 <br /> I i <br /> j <br /> I <br /> i <br /> 'I <br /> d <br />