Laserfiche WebLink
Underground Stomp Tank Cleanup FUnd <br /> DETAILED REVIEW CHECKLIST <br /> Claimant Name: <br /> Ec, <br /> ITFA—ewon., Priority Assigned: Site Name; <br /> . .......... <br /> RDM fleviewmvd: -,-17vdK7zK1 <br /> Site Address: ?2 . <br /> Lead A!Mftclf-. jDA IAI&- <br /> I <br /> Ciairrd&Own g)pperatorof UST <br /> 1 Tax IdLn"Ticitio dad <br /> 0 <br /> valid Third Party CIO(in. <br /> Joint Claimant OwnerlOostutor of UST <br /> Tax Mgntg1caflon Provided <br /> IrFmanclal AnreaMent Provided <br /> Tax Identification PTKiqq#__ <br /> Tank Desch Rg0Tank Use� <br /> Tank Substance <br /> Site Map Pm%Aded <br /> ._—.Current OwnerlOomtor Identified <br /> Date Ske/ranks Acquirecl I <br /> Ac uirsd After 1/1164/Rouonable 1311190 <br /> Past Owner/Oarator wentlied <br /> CMhw Claims Fof This Sfte submitto- <br /> Unauthorind R01m <br /> Release RaportedtConflimed <br /> Date Release Officovered Confirmed <br /> CatmOD&ck`lqW Re iratL <br /> Release Ell-glole not a salk o <br /> Corrective,Actlai <br /> Ralaam Prtorto 1/1/88,CA Initiated by8J3US 'lei <br /> Corrective Action in Gam (lance <br /> parmit <br /> Pormh Agagi!pments Met by 1!1196 <br /> Permit Waterer Oahu Pa4usstea <br /> Permit Waiver Granted <br /> 1FInanclat <br /> Cift <br /> Lawsuit.insurance Claim,Settlement <br /> Date Flied-Data <br /> Amount Received <br /> Original Siansturstr <br /> I Authorized Rapresentallys Stalarnflnl- <br /> L Joint Claimant Slanatura(s) 77 :i. <br /> USTCF02S.DF-T(Rev.1/05) <br /> zoo £1.b'ON aNnJ anNU310 isn 99:t7i L6/VO/60 <br />