Clean Construction or Demolition Debris (CCDD)
Fill Operations Forms
Beginning July 1, 2008, no person can use CCDD as fill material in a
current or former quarry, mine, or other excavation unless they have obtained a
permit from the Illinois EPA. You may complete the forms below online and save them on your computer before
printing and submitting them. To view Adobe
Acrobat PDF files, you will need the free Acrobat
Reader software, available from Adobe's
web site.
CCDD Fill
Operations with Approved Permits
Regulations for CCDD Effective August
30, 2012
Permit Application Forms
Application for Permit for Clean
Construction or Demolition Debris Fill Operations (LPC-PA25 Form)
Attachment A - Site Owner and
Site Operator Disclosure (LPC-PA25A Form)
Attachment B - Compliance with
Section 22.52 of the Act (LPC-PA25B Form)
Attachment C - Compliance with
Section 39(i-5) of the Act (LPC-PA25C Form)
39(i)
Certification for Individuals Form
39(i) Certification for Legal Entities
Notice of Application for Permit to
Manage CCDD (LPC-PA26)
Certification
of Authenticity of Official Forms
Note that the LPC-PA25 and 39(i) forms, certification of authenticity of official forms and the proof of notification of elected officials forms
are required for all permit applications for new CCDD fill sites or expansions
of existing sites. The other attachments may be necessary in response
to answers in the LPC-PA25 form. See the instructions in the
LPC-PA25 form
for details.
Permit Modification Forms
For modifying an existing, permitted CCDD Filll Site, a CCDD modification form,
Notice of Application for Permit to Manage CCDD form, and Certification of
Authenticity are required. Additionally, for Certification of Closure or
Certification of Completion of Post-Closure Care, the application must also
include the appropriate Affidavit. For transfer of owner or operator rights, the
LPC 661 form must be completed and
submitted with the applications.
CCDD Permit Modification Form
Affidavit for Certification of Closure
of CCDD Fill Sites
Affidavit for Certification of
Post-Closure Care of CCDD Fill Site
Certification
of Authenticity of Official Forms
CCDD Transfer Form
CCDD Transfer Form Instructions
Certification and Registration Forms
Source Site Certification by Owner
or Operator LPC-662
Uncontaminated Soil
Certification by Licensed Professional Engineer or Licensed Professional
Geologist LPC-663
Uncontaminated Soil
Fill Operation Registration Form by Owner and/or Operator LPC-665
Painted CCDD
Certification LPC-667
Miscellaneous Forms
CCDD Fee Form
CCDD Monthly Tons Record
CCDD Load Rejection Information
In accordance with a standard operating condition present in all permits issued
by the Illinois EPA to CCDD facilities, all CCDD facilities are required to
submit a completed CCDD Load Rejection
Form to the Illinois EPA after each instance of an incoming load being
rejected by the CCDD facility.
All permit applications downloaded off of the Internet and submitted to
Illinois EPA must be accompanied by
certification of
authenticity of official forms. You may also request paper copies by calling 217-524-3300. Completed
applications must be submitted by mail, personal delivery, or delivery service. Applications may not be submitted via fax or e-mail.
Please ensure that applications and all required attachments are completed in
full prior to their submission to the Illinois EPA. Incomplete applications will be
returned and will not be deemed submitted until a complete application is
provided.
Completeness checklist reviews are done within 30 days of receipt of a CCDD
permit application to determine if the application is administratively complete.
Complete applications are given technical reviews within 90 days of receipt of
the application to determine if the permit can be issued. The
completeness checklist and
technical checklist used by Illinois EPA reviewers may be useful.
Completed applications must be submitted to the following address:
Illinois EPA Mail Code #33
1021 North Grand Ave. East
P.O. Box 19276
Springfield, IL 62794-9276
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