(c)

1. (1) Any applications for reimbursement of corrective action costs must be submitted on forms provided by the Division of Environmental Quality and shall include an accounting of all charges itemized by labor hours and rates, analytical charges, equipment charges, and other categories that may be identified by the division.

2. (2) The application also shall contain the following:

   1. (A) The name, address, and telephone number of the applicant;
   2. (B) The name, address, and telephone number of each owner and operator of each storage tank and the facility owner, if different from the applicant;
   3. (C) The location of the facility where the corrective action was performed or is being performed, identified with sufficient clarity and detail to enable a person unfamiliar with the site to locate it;
   4. (D) A legible copy of all invoices for which reimbursement is requested, providing:

(i) A description of the work performed;

1. (ii) Where the work was performed;

   1. (iii) The dates the work was performed;

      1. (iv) The unit costs; and
      2. (v) The total amount paid;

   2. (E)

      1. (i) Evidence that the amounts shown on the invoices for which reimbursement is requested have been paid in full by the applicant.
      2. (ii) The evidence must be accompanied by a copy of any of the following:

(b) (b) Canceled checks (front and back);

1. (c) (c) The certification of a certified public accountant that the costs for which reimbursement is requested have been paid in full; or

   1. (d) (d) An affidavit signed by the person who performed the corrective action, affirming what amounts the applicant represents as being paid to that person have been paid in full; and

   2. (F) Any other information that the division may reasonably require.

      1. (d) An application must be signed as follows:

2. (1) For a corporation:

   1. (A) By a principal executive officer of at least the level of vice president;
   2. (B) By a duly authorized representative or agent of the executive officer named in subdivision (d)(1)(A) of this section, provided that the representative or agent is responsible for the overall operation of the facility that is the subject of the application; or
   3. (C) By a person whom the board of directors designates by means of a corporate resolution;
3. (2) For a partnership, sole proprietorship, or individual, by a general partner, the proprietor, or individual, respectively; or

4. (3) For a municipality, state, federal, or other public agency, by either:

   1. (A) A principal;
   2. (B) An executive officer; or
   3. (C) A ranking elected official.