
Ip. Items Original Purchase Date ADDRESS: PETROLEUM FUND CASE #: Description of Major / Minor equipment items purchased for a cost greater than $500 (i.e. SVE/AS system, pump and treat system, stripper, pump, modem, canister, etc.). Indicate None if no Fund equipment is located on site. Cost (nearest $500) Currently in use at site. (Yes or No) Final disposition of equipment no longer in use. Date available for use at another site. CODE 1 2 3 4 5 6 7.
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How to fill out the Accountability Form online
The Accountability Form is essential for documenting equipment inventory for reimbursement claims. This guide provides clear, step-by-step instructions to help you accurately complete the form online.
Follow the steps to effectively complete the Accountability Form.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering the site name and address in the designated fields. Ensure that the Petroleum Fund case number is also included.
- List each piece of equipment that was purchased for a cost greater than $500. Specify the description of each major or minor equipment item in the corresponding field. If there is no equipment located on site, please indicate ‘None’.
- For each item, enter the original purchase date and the cost, rounded to the nearest $500.
- Indicate whether each equipment item is currently in use at the site by selecting ‘Yes’ or ‘No’.
- For equipment items that are no longer in use, provide information about their final disposition, including the date they are available for use at another site and the specific code that applies to their status.
- Review the Disposition Agreement for Major Capital Remediation Equipment and ensure that you understand and agree to the terms.
- Affix the owner’s signature, along with the phone number, to confirm understanding of the form's content.
- Finally, save the changes made to the form, then download, print, or share it as required.
Complete your documents online today to ensure accurate and efficient processing.
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