Wash. Admin. Code § 173-360A-1097
Current through Register Vol. 24-12, June 15, 2024
The undersigned, as principals and as legal representatives of [insert owner or operator] and [insert name and address of third-party claimant], hereby certify that the claim of bodily injury [and/or] property damage caused by an accidental release arising from operating [owner's or operator's] underground storage tank should be paid in the amount of $[___].
[Signatures]
Owner or Operator
Attorney for Owner or Operator
(notary)
Date
[Signature(s)]
Claimant(s)
Attorney(s) for Claimant(s)
(notary)
Date
Wash. Admin. Code § 173-360A-1097
Reviser's note: The brackets and enclosed material in the text of the above section occurred in the copy filed by the agency and appear in the Register pursuant to the requirements of RCW 34.08.040.