Reasonable Rate Documents General State Trust Fund Documents Current Funding Levels Eligibility Documents Policy Proof of Payment Policy memo (10/18/05 pdf) Examples of acceptable forms of proof of payment of costs (pdf) Clarify Codes 3.399, 8.100 and 12.010 (10/19/05 doc) Statute of Limitations on filing Eligibility Applications and Reimbursement Claims Memo (11/9/08 pdf) Remedial System Certification Policy (10/15/03 pdf) Free Product Recovery Program Free Product Removal Program Preapproval/Claim Authorization Form (01/01/09 xls) List of Allowable Task Codes for Preliminary FP Evaluation (01/16/09 doc) List of Allowable Task Codes for Passive FP Recovery (doc) Reasonable Rate Document Updates Current Electronic Pre-Approval Task Authorization Note: Do not use special characters in Electronic Pre-Approval Task Authorization file names (e.g. “#”, “/,” “$”, etc.). Hyphens are acceptable. 2022 Reasonable Rate Updates 2020 RRD ERRATA (doc) 2020 (2022 Version) Task Scope of Work Document (doc) 2022 Claim Forms (xlsx) 2020 RRD EPATA w updated task codes UST_2020 RRD Price List (2022 Version) 2020 Reasonable Rate Documents 2020 Claim Preparation Checklist (doc) 2020 RRD Instructions for Completing Claims/Preapprovals (doc) 2020 RRD Task Scope of Work Document 2020 RRD Task/Analytical Price List 2020 RRD Claim Forms (xlsx) 2020 Project Summary Form (doc) 2020 Remedial System Certification Form (doc) 2020 Certification of Cost Form (doc) 2020 Certification of Payment Form (doc) 2020 Reimbursement Identification Form (doc) 2020 Electronic PreApproval Task Authorization Form (xlsx) 2017 Reasonable Rate Documents 2017 Claim Preparation Checklist (doc) 2017 RRD Instructions for Completing Claims/Preapprovals (doc) 2017 RRD Task Scope of Work Document, revised Revisions to Task 2.416 AND 7.361 in Response to 15A NCAC 2T .1500 Changes 2017 RRD Task Scope of Work AFVR and MMPE Memo 2017 RRD Task/Analytical Price List 2017 RRD Claim Forms (xlsx), revised 2017 Project Summary Form (doc) 2017 Remedial System Certification Form (doc) 2017 Certification of Cost Form (doc) 2017 Certification of Payment Form (doc) 2017 Reimbursement Identification Form (doc) 2016 Reasonable Rate Document for February 1, 2016 Commercial UST Funding Level Change Preliminary Risk Reevaluation Task List (2/2016 docx) Hard copies of the PATA form are no longer being accepted for manual processing. The current version of the ePATA form should be utilized for pre-approval requests.
Reasonable Rate Documents General State Trust Fund Documents Current Funding Levels Eligibility Documents Policy Proof of Payment Policy memo (10/18/05 pdf) Examples of acceptable forms of proof of payment of costs (pdf) Clarify Codes 3.399, 8.100 and 12.010 (10/19/05 doc) Statute of Limitations on filing Eligibility Applications and Reimbursement Claims Memo (11/9/08 pdf) Remedial System Certification Policy (10/15/03 pdf) Free Product Recovery Program Free Product Removal Program Preapproval/Claim Authorization Form (01/01/09 xls) List of Allowable Task Codes for Preliminary FP Evaluation (01/16/09 doc) List of Allowable Task Codes for Passive FP Recovery (doc) Reasonable Rate Document Updates Current Electronic Pre-Approval Task Authorization Note: Do not use special characters in Electronic Pre-Approval Task Authorization file names (e.g. “#”, “/,” “$”, etc.). Hyphens are acceptable. 2022 Reasonable Rate Updates 2020 RRD ERRATA (doc) 2020 (2022 Version) Task Scope of Work Document (doc) 2022 Claim Forms (xlsx) 2020 RRD EPATA w updated task codes UST_2020 RRD Price List (2022 Version) 2020 Reasonable Rate Documents 2020 Claim Preparation Checklist (doc) 2020 RRD Instructions for Completing Claims/Preapprovals (doc) 2020 RRD Task Scope of Work Document 2020 RRD Task/Analytical Price List 2020 RRD Claim Forms (xlsx) 2020 Project Summary Form (doc) 2020 Remedial System Certification Form (doc) 2020 Certification of Cost Form (doc) 2020 Certification of Payment Form (doc) 2020 Reimbursement Identification Form (doc) 2020 Electronic PreApproval Task Authorization Form (xlsx) 2017 Reasonable Rate Documents 2017 Claim Preparation Checklist (doc) 2017 RRD Instructions for Completing Claims/Preapprovals (doc) 2017 RRD Task Scope of Work Document, revised Revisions to Task 2.416 AND 7.361 in Response to 15A NCAC 2T .1500 Changes 2017 RRD Task Scope of Work AFVR and MMPE Memo 2017 RRD Task/Analytical Price List 2017 RRD Claim Forms (xlsx), revised 2017 Project Summary Form (doc) 2017 Remedial System Certification Form (doc) 2017 Certification of Cost Form (doc) 2017 Certification of Payment Form (doc) 2017 Reimbursement Identification Form (doc) 2016 Reasonable Rate Document for February 1, 2016 Commercial UST Funding Level Change Preliminary Risk Reevaluation Task List (2/2016 docx) Hard copies of the PATA form are no longer being accepted for manual processing. The current version of the ePATA form should be utilized for pre-approval requests.
