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SE.P.14.200iol 2 38PPPM WICKLHIVL CURFRP hu eial H 1 ;6 <br /> r ' ' <br /> r <br /> i <br /> CALAK?RMA UND1RGA0= STORAGE TANK CLEAIVW FUND ' <br /> COSTPRUAPFRQVAL RRQMT <br /> (Complete forth, enclow squired Ramat,tiStt,data d,return) ' <br /> TO, Linda Wborm l�a�t; (918)327-IS76. <br /> Z. CLAV4INFORMATION 006055 8. CLAIMAM Wickland Frowties <br /> A.CI.AU N'0. <br /> C. CLAVI SUMS (oam loW 1e ropridtr wetter) <br /> 1) LOC 1511M FORS 07,02 <br /> It) ON PRIQATIY L 5S 1245 M NO ile YES,PataRt7'Y CLASS A` 8 t; p <br /> iii) NOT YET APP=TO THE FLINT.P*ECTED APPLICATION I?A7E <br /> 0. CONTACT PERSON;----John MrApyaki P140IS11: <br /> ADDRESS; 'FAN., <br /> 11. <br /> JB PAE•APPAOVAL S 37127- 30 AIrfOLNT AFQLTSTEP <br /> 3-DID REVIF.1%, S PKrFl RRBD BID Of slsitiicahle) <br /> = a <br /> .TN£FOLLO�CiI40 DQCU1+IEhO'8 ARE AROU ED FOR THE SPECiF13D REQL'SST, ALL 0OC4TMN'7& <br /> -�: REQUESTED UST EE IMMITTED <br /> -TM fb M%1719 item'are rcqulred b4fora ruvwC and <br /> "-dowmlnmw M11 be=de b)'Fund Sass. <br /> f_ ,1.?A complait signed copy of Lha proposed 1n+,e10811fon WOrkplen or Corrective Action plan ICAP1 raft defined <br /> �t <br /> and requltad by Anicle U. Chapter 18. Cillromis Undcrjrottnd ILongo Taal.Reguloctonsl Corroative Aetfen <br /> -{ • �,r` Plans must Ircludo the rrq red foosibiliq study end chosen cost tlTective 4narottth'a, <br /> 2._%A signed cop of the everala, t awgann-epproval loiter tot the WorkplatVCAP. <br /> F - : 3,-E�,complolt cop; or the Ro4qni for DIU IneNdlnS All L,ttechments, A]Ist anall llrme requemod to bid must bo <br /> s,,� • Iltoludod. <br /> XCompldie topics oral)bldr 4nd othsr wee-upondona tubnlijted in roiponm tv jh#Acquast for 8100. ' <br /> �r a,3A time nbcdais. Irnol pram or bid dmmcnte.anticipated rorprtjoct I►tldnilon and dttrat1011 <br /> 6..&4 drtoilad proJim budge;. u Mall Inaiudca brralr'do%ns of ataR teEk"hdur with awolmad wini.ticd 101111 <br /> B. IrALV7dt�•l �{ALUAT 0Q&Tg \11'Q-AT1eSy. Fut;d staff%%III ttaatn an,+'platy»ant roqutsiinp in <br /> m-of ion ofbids upon ragvast. The follas%In; infornlatilan must ba iubmlliad - 1,:,3 AN-M 4 d4sr►iboA In <br /> sten. A above, <br /> IM widorp marl al`prrluml diet ell horniptlor,arrbmirrrd tt fall rl;rr r�Vrrar 1j cans 11�ta ar+d ae�rnate IPr ly arEerdarnr 1,1111> �a1twolltebl� r41ix mid rM�r.larlprr�. ;�il,"� n.e�tLl��.rini��i�rn�"r�"i7lf���.,1;rlr1 <br /> 'rt r <br /> S)9 t re Prints Name Dote <br /> , <br /> i1' ,1 toritatlan torr the Fund to 3lao pull!our nntna and phone nurnber to other elalmante fry your molort os a <br /> reNrance fbr consultants and cgntrAclors. 1'ES © 110 <br /> z ' <br /> S��neturo ate <br /> f/Z'd SZ20-299--0SS-353r'i-'$N3-039'1.S M EZ;VT We bx d3S � <br />