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a <br /> I <br /> 1 I�' <br /> UST CLAIM APPLICATION <br /> INSTRUCTIONS FOR PAGE ELEVEN } <br /> XII. SUPPORTING DOCUMENTATION CHECKLIST <br /> This checklist is being included with the Claim Application to assist ''he claimant in ensuring that all required <br /> documentation is being submitted. In finalizing this package, you are encouraged to check each box applicable <br /> to you as a method of verifying that the material is attached. # <br /> For a more complete description of the eligibility requirements and ti�a required documentation necessary to r <br /> approve and process the Claim Application, refer to the Program Information section of this package (unless <br /> otherwise stated) as identified with each item of the Checklist. <br /> I <br /> Estimate of Costs- Refer to Page 4, Item #8, Eligibility Requirements.!, <br /> Site Map- Refer to Page 3, Item #N, of Section V. Contaminated Site Description, of the Claim Application. <br /> Date Corrective Action Initiated Refer to Page 4, Eligibility Requirements. <br /> Priority Class A- Refer to Page 5, Priority Class. <br /> Priority Class B - Refer to Page 5 through.10, Priority Class; Governmental entities and non-profit organizations, <br /> refer to Page 10 through 11, Priority Class. <br /> Financial Responsibility- Refer to Page 7, Item #7, Eligibility Requirements; also Page 9, Section X. Financial <br /> Responsibility, of the Claim Application. 1 <br /> a <br /> Unauthorized Release of Petroleum - Refer to Page 2, Item #3, Eligibility Requirements. <br /> ) <br /> Permit to Own and/or Operate UST- Refer to Page 2, Item 6, Eligibility Requirements. <br /> Corrective Action Compliance- Refer to Page 2, Item #4, Eligibility Requirements. <br /> f <br /> j Co-Payee Agreement- Refer to Page 2, Section IV. Co-Payee, of the Claim Application. ; <br /> i <br /> I� <br /> l <br /> I I <br /> j <br /> f <br /> '6 <br /> d <br /> Ali <br /> I f <br /> i <br /> 'l <br /> F <br />