Municipal Solid Waste Landfill Post Closure Plan (329 IAC 10-23) {50388}

MUNICIPAL SOLID WASTE LANDFILL POST-CLOSURE PLAN (329 IAC 10-23) State Form 50388 (R2/6-06) Indiana Department of Environmental Management INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Office of Land Quality Solid Waste Permits Section - Mail Code 65-45 100 N. Senate Ave., Rm. 1154 Indianapolis, IN 46204-2251 INSTRUCTIONS This application form shall be used to submit post-closure plans for municipal solid waste landfills (MSWLFs) both individually and with permit applications. When completed, post-closure plans should be submitted, either individually or with permit applications, along with support documentation, to the address given in the box above. I. General Information Facility Name Facility Location Facility County Facility Solid Waste Permit No. (if existing permitted facility) II. Post-Closure Contacts A. Facility Owner Typed Name Typed Address State ZIP Street P.O. Box Phone (with area code) Town/City B. Operator Typed Name Typed Address State ZIP Street P.O. Box Phone (with area code) Town/City C. Permittee Typed Name Typed Address State ZIP Street P.O. Box Phone (with area code) Town/City III. Ground Water Monitoring Activities Provide a description of planned ground water monitoring activities and the frequency with which they will be conducted (see instructions). Attach additional sheets as necessary. Page 1 of 12 Although this form is being provided to aid you in preparing your post-closure plan in accordance with the solid waste rules, this form is subject to review and revision. Please consult the actual rule language. American LegalNet, Inc. www.FormsWorkflow.com III. Ground Water Monitoring Activities (continued) Page 2 of 12 Although this form is being provided to aid you in preparing your post-closure plan in accordance with the solid waste rules, this form is subject to review and revision. Please consult the actual rule language. American LegalNet, Inc. www.FormsWorkflow.com IV. Description of Planned Maintenance Activities Provide a description of planned maintenance activities and the frequency with which they will be conducted. Attach additional sheets as necessary. Page 3 of 12 Although this form is being provided to aid you in preparing your post-closure plan in accordance with the solid waste rules, this form is subject to review and revision. Please consult the actual rule language. American LegalNet, Inc. www.FormsWorkflow.com V. Description of Planned Uses of Property during the Post-Closure Period Provide a description of planned uses of the property during the 30-year post-closure period. Attach additional sheets as necessary Page 4 of 12 Although this form is being provided to aid you in preparing your post-closure plan in accordance with the solid waste rules, this form is subject to review and revision. Please consult the actual rule language. American LegalNet, Inc. www.FormsWorkflow.com VI. Post-Closure Cost Estimate Please see instructions; attach additional sheets as necessary. A. Cost for Semi-Annual Inspections and Reports 1. Inspection a. b. c. d. 2. Number of inspections during post-closure period (semi-annual inspections for 30 years) Inspector time required (hrs/insp) Inspector time labor cost ($/hr) Inspection cost ($) Line 1.a * line 1.b * line 1.c 60 Report Preparation a. b. c. Number of reports during post-closure period Cost per report ($) Report cost Line 2.a * line 2.b 60 3. B. TOTAL COST, INSPECTIONS AND REPORTS ($) Line 1.d. + line 2.c Cost for Maintenance of Final Cover and Vegetation/Vegetation Control 1. Final Cover Maintenance The cost for cover maintenance and vegetation shall be 10% of the cost per acre calculated for final cover and vegetation in the closure plan (329 IAC 10-23-3(c)(5)(A)). a. b. c. 2. 10% of cost for placement of final cover and vegetation (0.10 * cost given in Item VII.I of the closure plan) Total permitted fill acreage Total Cost, Maintenance of Final Cover and Vegetation Cover Line 1.a * line 1.b Vegetation Control Costs a. b. c. d. e. Mowing frequency (visits/30 years) Area to be mowed (acres/visit) Mowing unit cost ($/acre) Total mowing cost ($) Line 2.a * line 2.b * line 2.c Other ($) ­ specify below (weed control for well access, etc.) Total other: f. 3. Vegetation Control Costs Line 2.d + line 2.e TOTAL COST FOR MAINTENANCE OF FINAL COVER AND VEGETATION Line 1.c + line 2.f Page 5 of 12 Although this form is being provided to aid you in preparing your post-closure plan in accordance with the solid waste rules, this form is subject to review and revision. Please consult the actual rule language. American LegalNet, Inc. www.FormsWorkflow.com C. Cost for Leachate Treatment and Disposal (see instructions) 1. Leachate Volume Requiring Disposal 2. Gallons Per Acre Per Day (150) (80) (50) (30) (20) (10) 3. Total Permitted Fill Acreage 4. Total Gallons Per Day (col. 2 * col. 3) 5. Total Gallons for 5-yr Period (col. 4 * 365 days * 5 years) 1. Post-Closure 5-yr Period Years 1-5 Years 6-10 Years 11-15 Years 16-20 Years 21-25 Years 26-30 TOTAL GALLONS, 30 YEARS 2. Leachate Pumping & Hauling a. b. c. d. e. f. Leachate removal frequency (visits/30 years) Quantity to be managed off-site/on-site per visit (TOTAL GALLONS, 30 YEARS ÷ no. visits, line 2.a.) Truck capacity (gallons) Number of loads each time leachate is removed Line 2.b ÷ line 2.c Pumping and transportation unit cost Leachate hauling cost Line 2.a * line 2.d * line 2.e 3. Cost for Leachate Treatment and Disposal a. b. d. Total gallons requiring leachate treatment/disposal over 30 years (from total, TOTAL GALLONS, 30 YEARS, above) Treatment/disposal unit cost ($/gal) Leachate disposal cost Line 3.a * line 3.b 4. D. TOTAL COST, LEACHATE PUMPING & HAULING, TREATMENT AND DISPOSAL Line 2.f + line 3.c Cost for Leachate Collection System Monitoring and Maintenance) 1. Leachate Collection System Inspection a. b. c. d. 2. Inspection frequency (insp/30 years) Inspection time required (hrs/insp) Inspector unit labor cost ($/hr) Inspection cost ($) Line 1.a * line 1.b * line 1.c Leachate Collection System Maintenance a. b. Number of pumps replaced during post-closure (pumps/30 years) Pump unit cost ($/pump) Page 6 of 12 Although this form is being provided to aid you in preparing your post-closure plan in accordance with the solid waste rules, this form is subject to review and revision. Please consult the actual rule language. American LegalNet, Inc. www.FormsWorkflow.com c. Other ($) ­ specify below Total other: d. 3. E. Leachate collection system