Bureau of Land

Permit Forms and Instructions

All permit applications downloaded off of the Internet and submitted to Illinois EPA must be accompanied by certification of authenticity of official forms. To request original forms for the proposed activity you may call the Bureau of Land Permit Section at 217/524-3300 or submit your request electronically. Please be sure to identify the form or forms you need along with a complete mailing address and a phone number in case we have questions.

Please send all completed forms to:
Permit Section - Bureau of Land
Illinois Environmental Protection Agency
1021 North Grand Avenue East #33
Springfield, IL  62794-9276

Siting

A completed LPC-PA8: Siting Certification Form must accompany any application for a permit for a new pollution control facility, as defined in Section 3.330 of the Illinois Environmental Protection Act.  Siting, the process that the local government uses to approve the site location, must be completed before submitting an application for a new facility and certain modifications to an existing facility. However, not all new facilities must get local siting approval.  Examples of those facilities that may not need local siting approval include: hazardous facilities that treat their own waste on-site, landscape waste composting facilities, and transfer stations that are used exclusively to transfer landscape waste within 24 hours after it is received.  The process to obtain siting approval is described in Section 39.2 of the Illinois Environmental Protection Act.

Request Forms

Permits - Solid Waste Forms

Supplemental Permit Applications

A Supplemental Permit Application is required to request a change for a facility permitted under 35 IAC Part 807. When submitting a Supplemental Permit Application, the General Application for Permit (LPC-PA1), the Notice of Application for Permit to Manage Waste (LPC-PA16) and a description of the proposed modification need to be provided. Depending on the nature of the application and other facility-specific factors, additional forms may be required.

Significant Modification Permit Applications

A Significant Modification Permit Application is required to request a change for a landfill permitted under 35 IAC Parts 810 through 817. When submitting a Significant Modification Permit Application, the General Application for Permit (LPC-PA1), the Notice of Application for Permit to Manage Waste (LPC-PA16) and a description of the proposed modification need to be provided. Depending on the nature of the application and other facility-specific factors, additional forms may be required.

Beneficial Use Determination Applications

A beneficial use determination application is needed to request a determination from the Agency that a material is being used beneficially and is not a waste. Applications must demonstrate compliance with Section 22.54 of the Illinois Environmental Protection Act. Form LPC-PA27 and the additional information identified in the instruction to LPC-PA27, including a process description, analysis and affidavits or certifications, must be included in the application.

All Permit Applications  - these forms are fillable online.

• Certification of Authenticity - required to be submitted with any form downloaded from the Internet.
• General Instructions
• LPC-PA1: General Application for Permit (Not needed with LPC-PA12)
• LPC-PA16: Notice of Application for Permit to Manage Waste

Applications for New Nonhazardous Waste Facilities, by Facility Type

• LPC-PA2: Landfill Development Permit Application
• LPC-PA3: Application for a Permit to Develop Treatment and/or Storage Facilities 
• LPC-PA5: Application for a Permit - Non-Special Municipal Waste Storage/Transfer Station
• LPC-PA6: Application for a Permit to Develop a Composting Facility
• LPC-PA8: Certification of Siting Approval
• LPC-PA12: Application for a Permit to Develop a Landscape Waste Compost Facility
• LPC-PA17: Application for a Potentially Infectious Medical Waste (PIMW) Management Permit to Develop Treatment and/or Storage-Transfer Facilities

Applications/Certifications Regarding Closure or Post-Closure Care of a Permitted Facility

• LPC-PA11: Closure Plans and Post-Closure Care Plans
• Affidavit For Certification of Closure of Permitted Non-Hazardous Transfer, Storage and Treatment Waste Facilities
• Affidavit For Certification of Completion of Post-Closure Care for Non-Hazardous Waste Facilities
• Affidavit For Certification of Closure of Non-Hazardous Waste Facilities
  
• Affidavit for Certification of Closure of Solid Waste Landfills

Miscellaneous Solid Waste Permit Forms and Guidance

• LPC-PA4: Application for Operating Permit
• LPC-PA7: Application for the Transfer of Solid Waste Permits
• LPC-PA9: Signatures of all Beneficiaries of a Land Trust
• LPC-PA19: Instructions for a Significant Modification for Demonstrating Compliance with IAC, Subtitle G, Part 814, Subpart C
• LPC-PA27 Beneficial Use Determination (BUD) Application and Instructions     (PDF, 512 KB)
• Compost Facility Financial Assurance Certification
• Solid Waste Groundwater, Leachate, Facility and Gas Reporting Form - LPC-591
• Treatment of Petroleum Contaminated Soils
• Application for Prior Conduct Certification
• Part 814 Subpart C New Facilities Groundwater Monitoring
• Changes to Leachate Management/Monitoring Conditions
• 39(i) Certification for Operating a Waste Management Facility for Individuals
• 39(i) Certification for Operating a Waste Management Facility for a Legal Entity

Permits - Hazardous Waste Forms

All Permit Applications  - these forms are fillable online.

• Certification of Authenticity   required to be submitted with any form downloaded from the Internet
• LPC-PA23: RCRA Permit Application Instructions and Form   

New and Renewed RCRA Permit Applications

• Part A Permit Application Form
• RCRA Hazardous Waste Permit Application Decision Guide
• Hazardous Waste Permit Application Completeness and Technical Evaluation Checklist

Hazardous Remediation Waste Permit Applications

• Fact Sheet for RCRA Remedial Action Plan Permit (RAPP)
• Instructions for the Application of a RCRA Remedial Action Plan Permit (RAPP)  

Closure Plans and Corrective Action

• RCRA Interim Status Closure Guidance Document
• LPC-PA18: RCRA Interim Status Closure & Post-Closure Care Plan (General Form)
• RCRA Interim Status Closure Certification Statement
• RCRA Corrective Action Certification

Miscellaneous Hazardous Waste Forms and Guidance

• RCRA Facility Groundwater, Leachate and Gas Reporting Form (LPC-592)
• LPC-PA8: Siting Certification
• LPC-PA9: Signatures of all Beneficiaries of a Land Trust
• LPC-PA10: Request for Authorization to Deposit Hazardous Waste under Section 39(H)
• Application for Prior Conduct Certification
• 39(i) Certification for Operating a Waste Management Facility for Individuals
• 39(i) Certification for Operating a Waste Management Facility for a Legal Entity

Permits - Groundwater Forms

• Field Boring Log Form:  Characterization of the geology, sample depths, depth to groundwater, etc.  This form must be utilized in conjunction with a Monitoring Well Completion Form.  One completed form must be submitted for each groundwater monitoring well installed.
• Monitoring Well Completion Form: Construction details for a groundwater monitoring well. This form must be utilized in conjunction with a Field Boring Log Form. One completed form must be submitted for each groundwater monitoring well installed.
• Monitoring Well Diagram : Graphic of the construction details of a groundwater monitoring well. This form should be used for guidance purposes when installing a groundwater monitoring well.
• Well Plugging Procedures: Step-by-step procedures for the plugging and abandonment of a groundwater monitoring well.
• LPC-PA19: Instructions for a Significant Modification Demonstrating Compliance with 35 IAC, Subtitle G, Part 814, Subpart C.
• Appendix C to LPC-PA2: Instructions for the Groundwater Protection Evaluation for Putrescible and Chemical Waste Landfills (Attachment 1 from LPC-PA19 is the most recent and should be used for the monitoring constituents)