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Once you have determined the Priority Class for this Claim Application, please fill out the <br /> information requested for that Priority Class. Refer to the Program Information Section of this <br /> package for the required documentation to support the Priority Class being claimed. <br /> DOCUMENTS MUST BE SUBMITTED FOR THE CLAIMANT AND EACH JOINT CLAIMANT. <br /> IC .�4SS A - RESIL?ET'T <br /> IF CLAIMING CLASS A — RESIDEN'i'IA1 ,('1IIiCK'I'IIIS 13OX AND COMPIJ`MT 'I'IIE APPLICABI.1'. <br /> SE(7110N BELOW: <br /> A. B. <br /> Check this box if the underground Check this box if the underground <br /> storage tank which is the subject of this storage tank which is the subject of this <br /> claim contains HOME HEATING OIL and claim contains PETROLEUM and meets <br /> meets ALL of the following criteria: ALL of the following criteria: <br /> > The small home heating oil tank was located at the residence of > The petroleum underground storage tank was located on <br /> the claimant at the time of the discovery of the release; AND property used exclusively for residential purposes atthe time <br /> of the discovery of the release; AND <br /> > The residence was owner—occupied and a single family <br /> dwelling or duplex at the time of the discovery of the release; > The petroleum underground storage tank was located at the <br /> AND residence of the c,aimant at the time of the discovery of the <br /> release, AND <br /> > The tanK has a capacity of 1,100 gallons or less, and stores <br /> home heating oil for consumptive use on the premises where > The residence was owner—occupied and a single family <br /> stored: AND dwelling or duplex at the time of the discovery of the release: <br /> AND <br /> > Tne tank is not located on property used for agricultural <br /> purposes on and after January 1, 1985; AND > The tank is not a"Farm Tank" (a tank with a capacity of 1,100 <br /> gallons or less which is located on a farm and which stores <br /> >- The tank is not a"Farm Tank" (a tank with a capacity of 1,100 motor vehicle fuel used primarily for agricultural purposes and <br /> gallons or less which is located on a farm and which stores not for resale) and has not been used on or after January 1. <br /> motor vehicle fuel used primarily for agricultural purposes and 1985,for agricultural purposes. <br /> not for resale) and has not been used on or after January 1, <br /> 1985, for agricultural purposes. <br /> > NOTE: This small home heating oil tank is not subject to the > NOTE: This petroleum underground storage tank is suo;ect <br /> permit requirements of Chapter 6.7 of the H&SC. to the permit requirements of Chapter 6.7 of the <br /> H&SC. <br /> NOTE: REFER TO PROGRAM INFORMATION FOR REQUIRED DOCUMENTATION TO SUPPORT THE ABOVE CLAIMED <br /> STATEMENT. THIS DOCUMENTATION MUST BE SUBMITTED AT THE TIME OF APPLICATION.. <br /> (REVISED 1/94) (SEE FACING PAGE FOR INSTRUCTIONS) PAGE <br />