Nebraska Department of
Environmental
Quality

Applications and Forms

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This information is
provided by the
Nebraska Department
of Environmental Quality
to assist the
public and regulated community.

08-023a
Revised:
11/2008
Title 200 Program - Reasonable Rate Schedule
This Complete Document is only available as an Adobe Acrobat (PDF) file.
File size is 167 KB
08-023.pdf
The Guidance Document
Reasonable Rate Schedule
and
Reimbursement Guidance Manual
Get Adobe Reader
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Note: Effective Oct. 1, 2009, any individual submitting any application or form that would derive public benefit from the state must also fill out a United States Citizenship Attestation form. This applies to individuals submitting the forms on their own behalf. If applicable, please fill out the United States Citizenship Attestation form below and submit it with the relevant applications and forms.

United States Citizenship Attestation Form
This Complete Form is only available as an Adobe Acrobat (PDF) file.
File size is 97 KB

The Documents & Applications
"Title 200 Program - Petroleum Release Remedial Action Cash Fund"
have been converted to Adobe PDF format. You will need the Adobe Acrobat Reader to view these documents.
Title 200 Program Application for Reimbursement - Blank Form
Size 111 KB
Title 200 Program Application for Reimbursement - Online Form
Size 25 KB
APPFORM.pdf
Application Form Instructions

Size 45 KB
APP_INST.pdf
Application For Low Volume Classification
Size 16 KB
LV_APP.pdf
Application For Low Volume Classification Instructions
Size 22 KB
LV_INST.pdf
Application for Classification as a Voluntary Responsible Person
Size 15 KB
VRP_APP.pdf
Application for Classification as a Voluntary Responsible Person
Instructions
Size 16 KB
VRP_INST.pdf

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Nebraska Department of Environmental Quality
1200 "N" Street, Suite 400
P.O. Box 98922
Lincoln, Nebraska 68509
(402) 471-2186