9VAC20-170-400:9: APPENDIX IX.
Where this section sits in the code
- Title 9. Environment
- Agency 20. Virginia Waste Management Board
- Chapter 170. Transportation of Solid and Medical Wastes on State Waters
- Part VI. Financial Responsibility Requirements for Vessels Transporting Solid Wastes or Regulated Medical Wastes
- Article 2. Facility Closure
APPENDIX IX.
(NOTE: Instructions in brackets are to be replaced with the relevant information and the brackets deleted.)
CERTIFICATION OF VALID CLAIM
The undersigned, as principals and as legal representatives of [insert vessel 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 a sudden and/or nonsudden accidental occurrence arising from a waste deposit from [owner or operator] vessel into state waters should be paid in the amount of $[ ].
[Signatures]
Vessel Owner or Operator
Attorney for Owner or Operator
[Notary] [Date]
[Signature(s)]
Claimant(s)
Attorney(s) for Claimant(s)
[Notary] [Date]
Collected 2026-09-14T04:49:03Z. Source file · JSON